A comparison study of a novel stimulation protocol and the conventional low dose step-up and step-down regimens in patients with polycystic ovary syndrome undergoing in vitro fertilization.

Abstract:

OBJECTIVE:To compare the efficacy of a sequential step-up/step-down protocol with the conventional low dose step-up and the step-down regimens in patients with polycystic ovary syndrome (PCOS) undergoing IVF. DESIGN:Prospective randomized study. SETTING:Private fertility clinic. PATIENT(S):Two hundred twenty-five, 30-year-old or younger, women with PCOS. INTERVENTION(S):The low dose step-up, the step-down, and a sequential step-up/step-down regimens were used. MAIN OUTCOME MEASURE(S):Ovarian response, pregnancy (PR) and miscarriage rate. RESULT(S):Patients in group A (low dose step-up) exhibited the highest cancellation rate, whereas subjects in group C (sequential regimen) the lowest. The hormonal dosage (ampules) and duration of stimulation (days) was higher in group A patients and lower in group B (step-down regimen). The follicular growth uniformity was superior in group C patients who also achieved a higher number of eggs at retrieval, better fertilization and embryo development rates. The sequential group yielded the highest pregnancy and the lowest miscarriage rate. CONCLUSION(S):The sequential step-up/step-down stimulation protocol is superior to the low dose step-up and step-down regimens with regard to ovarian response, PR and miscarriage rate in 30-year-old or younger patients with PCOS undergoing IVF.

journal_name

Fertil Steril

journal_title

Fertility and sterility

authors

Koundouros SN

doi

10.1016/j.fertnstert.2007.06.080

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

569-75

issue

3

eissn

0015-0282

issn

1556-5653

pii

S0015-0282(07)01434-3

journal_volume

90

pub_type

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