TY - JOUR
T1 - Gonadotropin dose is negatively correlated with live birth rate
T2 - Analysis of more than 650,000 assisted reproductive technology cycles
AU - Baker, Valerie L.
AU - Brown, Morton B.
AU - Luke, Barbara
AU - Smith, George W.
AU - Ireland, James J.
N1 - Funding Information:
Supported by National Institutes of Health/National Institute of Child Health and Human Development grant P01 HD065647-01A1 .
Publisher Copyright:
© 2015 American Society for Reproductive Medicine.
PY - 2015/11
Y1 - 2015/11
N2 - Objective To evaluate the correlation between total gonadotropin dose and live birth rate. Design Retrospective analysis. Setting Not applicable. Patient(s) A total of 658,519 fresh autologous cycles of in vitro fertilization (IVF) reported to the Society for Assisted Reproductive Technology from 2004 to 2012. Intervention(s) None. Main Outcome Measure(s) Logistic regression models were fitted to live birth rates with the use of categorized values for total FSH dose and number of oocytes retrieved as the primary predictor variables. To reduce the effect of the most significant confounders that may lead physicians to prescribe higher doses of FSH, additional analyses were performed limited to good-prognosis patients (<35 years of age, body mass index <30 kg/m2, and no diagnosis of diminished ovarian reserve, endometriosis, or ovulatory disorder) and including duration of gonadotropin treatment. Result(s) Live birth rate significantly decreased with increasing FSH dose, regardless of the number of oocytes retrieved. The statistically significant decrease in live birth rate with increasing FSH dose remained in patients with good prognosis, and regardless of female age, except for women aged ≤35 years with 1-5 oocytes retrieved. Conclusion(s) This analysis suggests that physicians may wish to avoid prescribing a high dose of FSH. However, the results of this study do not justify the use of minimal-stimulation or natural-cycle IVF.
AB - Objective To evaluate the correlation between total gonadotropin dose and live birth rate. Design Retrospective analysis. Setting Not applicable. Patient(s) A total of 658,519 fresh autologous cycles of in vitro fertilization (IVF) reported to the Society for Assisted Reproductive Technology from 2004 to 2012. Intervention(s) None. Main Outcome Measure(s) Logistic regression models were fitted to live birth rates with the use of categorized values for total FSH dose and number of oocytes retrieved as the primary predictor variables. To reduce the effect of the most significant confounders that may lead physicians to prescribe higher doses of FSH, additional analyses were performed limited to good-prognosis patients (<35 years of age, body mass index <30 kg/m2, and no diagnosis of diminished ovarian reserve, endometriosis, or ovulatory disorder) and including duration of gonadotropin treatment. Result(s) Live birth rate significantly decreased with increasing FSH dose, regardless of the number of oocytes retrieved. The statistically significant decrease in live birth rate with increasing FSH dose remained in patients with good prognosis, and regardless of female age, except for women aged ≤35 years with 1-5 oocytes retrieved. Conclusion(s) This analysis suggests that physicians may wish to avoid prescribing a high dose of FSH. However, the results of this study do not justify the use of minimal-stimulation or natural-cycle IVF.
KW - In vitro fertilization
KW - gonadotropin dose
KW - live birth rate
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U2 - 10.1016/j.fertnstert.2015.07.1151
DO - 10.1016/j.fertnstert.2015.07.1151
M3 - Article
C2 - 26297646
AN - SCOPUS:84946485469
SN - 0015-0282
VL - 104
SP - 1145-1152.e5
JO - Fertility and sterility
JF - Fertility and sterility
IS - 5
ER -