Less is more: increased gonadotropin use for ovarian stimulation adversely influences clinical pregnancy and live birth after in vitro fertilization

Lubna Pal, Sangita Jindal, Barry R. Witt, Nanette Santoro

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Objective: To determine if attempts to maximize oocyte yield during ovarian stimulation translates into improved outcome of in vitro fertilization (IVF) cycles. Design: Retrospective study. Setting: Academic tertiary care IVF center. Patient(s): 806 de-identified nondonor IVF cycles. Intervention(s): Evaluation of fresh nondonor IVF cycles (n = 806) for the period January 1, 1999, to December 30, 2001. Main Outcome Measure(s): Cycle cancellation, clinical pregnancy, spontaneous miscarriage, and live birth after IVF. Result(s): Advancing age, independent of ovarian reserve status (reflected by early follicular phase FSH and estradiol) augured a worse prognosis for all outcomes. Higher gonadotropin use lowered cycle cancellations but was associated with a statistically significantly reduced likelihood of clinical pregnancy and live birth and a trend toward a higher likelihood for spontaneous miscarriage after IVF. Conclusion(s): Our data add to the accruing literature suggesting adverse influences of excess gonadotropin use on IVF outcomes. Although an aggressive approach to controlled ovarian hyperstimulation results in a statistically significant reduction in cycle cancellations, the excessive use of gonadotropins detrimentally influences live birth after IVF.

Original languageEnglish (US)
Pages (from-to)1694-1701
Number of pages8
JournalFertility and Sterility
Volume89
Issue number6
DOIs
StatePublished - Jun 1 2008

Keywords

  • In vitro fertilization
  • clinical pregnancy
  • cycle cancellation
  • gonadotropin stimulation
  • live birth
  • spontaneous miscarriage

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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