Minimum ovarian stimulation involving combined clomiphene citrate and estradiol treatment for in vitro fertilization of Bologna-criteria poor ovarian responders
| Autor: | Mari Kitade, Noriko Katoh, Keiji Kuroda, Satoru Takeda, Azusa Shinjo, Makoto Jinushi, Rie Ozaki, Jun Kumakiri, Yuko Ikemoto |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
030219 obstetrics & reproductive medicine In vitro fertilisation business.industry medicine.medical_treatment media_common.quotation_subject Uterus Obstetrics and Gynecology Stimulation Embryo Oocyte Andrology 03 medical and health sciences 0302 clinical medicine Endocrinology medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine Follicular phase medicine business Ovulation Hormone media_common |
| Zdroj: | Journal of Obstetrics and Gynaecology Research. 42:178-183 |
| ISSN: | 1341-8076 |
| DOI: | 10.1111/jog.12862 |
| Popis: | Aim: The aim of this study was to assess the efficacy of a minimal ovarian stimulation involving combinedclomiphene citrate (CC) and estradiol (E2) administration for poor responders with diminished ovarian reserve(DOR).Material and Methods: In this case–control study, we recruited 41 consecutive hypergonadotropic poorresponders (69 cycles) who met Bologna-criteria and had experienced cancellation of oocyte retrieval. In10 (20 cycles), 11 (21 cycles) and 20 patients (28 cycles) between 2012 and 2014, follicular developmentwas induced using an E2 cycle, CC cycle and CC + E2 cycle, respectively. After confirmation of highfollicle-stimulating hormone levels (15–40 mIU/ml) at menstrual day 3, DOR patients were treated withoral E2 of 1.0 mg/day, CC of 100 mg/day, or both CC and E2 continuously, until ovulation induction.Twodayslater,wetransvaginallyaspiratedthefollicles,performedinvitrofertilization,andcryopreservedthe cleavage embryos. One warmed embryo was transferred into the uterus during the hormone replacementcycles.Results: For the E2, CC, and CC + E2 cycles, the median patient age was 41 years in all groups, and the serumanti-Mullerian hormone levels were 0.2 ± 0.3, 0.4 ± 0.4, and 0.2 ± 0.3 ng/mL, respectively (P = 0.258); folliculardevelopment failure rates were 50.0%, 19.0%, and 3.6%, respectively (P < 0.001); numbers of retrieved oocytes(/cycle)were 0.5 ± 0.6,0.8 ± 0.7,and 1.2 ± 1.1,respectively (P = 0.033); and clinicalpregnancyrates(/cycle) were5.0%, 4.8%, and 10.7%, respectively (P =0.725).Conclusion: CC + E2 administration for the patients with DOR was effective with a lower cancellation rate ofoocyte retrieval and a higher number of retrieved oocytes. © 2015 Japan Society of Obstetrics and GynecologyKey words: clomiphene citrate, diminished ovarian reserve, estrogen replacement, in vitro fertilization, minimalovarian stimulation. |
| Databáze: | OpenAIRE |
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