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

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

Research output: Contribution to journalArticle

46 Citations (Scopus)

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 2008

Fingerprint

Ovulation Induction
Live Birth
Fertilization in Vitro
Gonadotropins
Pregnancy
Spontaneous Abortion
Follicular Phase
Tertiary Healthcare
Oocytes
Estradiol
Retrospective Studies
Outcome Assessment (Health Care)

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Less is more : increased gonadotropin use for ovarian stimulation adversely influences clinical pregnancy and live birth after in vitro fertilization. / Pal, Lubna; Jindal, Sangita K.; Witt, Barry R.; Santoro, Nanette.

In: Fertility and Sterility, Vol. 89, No. 6, 06.2008, p. 1694-1701.

Research output: Contribution to journalArticle

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