Individualization of the starting dose of follitropin delta reduces the overall OHSS risk and/or the need for additional preventive interventions: cumulative data over three stimulation cycles
| Autor: | A. Albert Yuzpe, Joan-Carles Arce, Hana Visnova, Manuel Fernández-Sánchez, Bernadette Mannaerts, Bjarke Mirner Klein |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Risk endocrine system medicine.medical_specialty Adolescent medicine.medical_treatment Ovarian hyperstimulation syndrome Stimulation Fertilization in Vitro Intracytoplasmic sperm injection Ovarian Hyperstimulation Syndrome Young Adult Ovulation Induction Internal medicine medicine Humans Dosing Sperm Injections Intracytoplasmic Cryopreservation business.industry Incidence (epidemiology) Ovary Obstetrics and Gynecology medicine.disease Recombinant Proteins Regimen Treatment Outcome Reproductive Medicine Quartile Data Interpretation Statistical Female Follicle Stimulating Hormone Human business Developmental Biology Hormone |
| Zdroj: | Reproductive biomedicine online. 38(4) |
| ISSN: | 1472-6491 |
| Popis: | Research question Is individualization of dosing with follitropin delta in sequential ovarian stimulation cycles an effective preventive strategy for ovarian hyperstimulation syndrome risk? If so, for which patients does an individualized strategy provide the greatest OHSS risk reduction and/or the need for additional preventive interventions? Design A secondary analysis of three ovarian stimulation cycles in IVF/intracytoplasmic sperm injection patients included in one randomized, assessor-blinded trial comparing two recombinant FSH preparations (ESTHER-1, NCT01956110), and a second trial in women undergoing up to two additional cycles (ESTHER-2, NCT01956123). Of 1326 women (aged 18–40 years) randomized and treated with follitropin delta or alfa in cycle 1, 513 continued to cycle 2 and 188 to cycle 3. Follitropin delta and alfa doses were maintained/adjusted according to ovarian response in the previous cycle. Results Individualized dosing with follitropin delta significantly reduced moderate/severe OHSS and/or preventive interventions (P=0.018) versus conventional dosing with follitropin alfa in patients undergoing up to three ovarian stimulation cycles. The greatest benefit was observed in patients in the highest anti-Mullerian hormone (AMH) quartile (P=0.012). On evaluating separately, individualized dosing with follitropin delta significantly lowered the incidences of moderate/severe OHSS (P=0.036) and preventive interventions (P=0.044) versus follitropin alfa. Conclusion An individualized follitropin delta dosing regimen decreased the risk of moderate/severe OHSS as well as the incidence of preventive interventions versus a conventional follitropin alfa regimen. An analysis per AMH quartile indicated that these statistically significant differences are driven mainly by patients with the highest pretreatment AMH levels. |
| Databáze: | OpenAIRE |
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