Fertility and sterility · 2008
The impact of LH-containing gonadotropin stimulation on euploidy rates in preimplantation embryos: antagonist cycles.
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Weghofer Andrea, Munné Santiago, Brannath Werner, Chen Serena, Barad David, Cohen Jacques, Gleicher Norbert
Аннотация
OBJECTIVE: To evaluate effects of luteinizing hormone (LH)-containing gonadotropins (human menopausal gonadotropin, hMG) on ploidy of human cleavage-stage embryos in gonadotropin releasing hormone (GnRH) antagonist cycles.
DESIGN: Retrospective matched cohort study.
SETTING: Two academically affiliated private fertility centers, private preimplantation genetics laboratory, and medical school.
PATIENTS(S): One hundred four consecutive in vitro fertilization cycles (IVF) with preimplantation genetic diagnosis in women aged 30 to 45 years.
INTERVENTION(S): Antagonist cycles with ovarian stimulation by either recombinant follicle stimulating hormone (FSH) alone, or in combination with human menopausal gonadotropin (FSH/hMG).
MAIN OUTCOME MEASURE(S): After matching patients for age and gonadotropin dosage, embryo ploidy, pregnancy, and miscarriage rates were evaluated.
RESULT(S): Euploidy rates (FSH, 29.4% vs. FSH/hMG, 25.7%) and number of euploid embryos (FSH, 2.1 +/- 1.6 vs. FSH/hMG, 1.9 +/- 1.5) were similar between both groups, although trended in favor of FSH-only stimulation. FSH-only stimulation, however, demonstrated significantly higher clinical pregnancy rates per cycle start (FSH: 34.6% vs. FSH/hMG: 11.5%) and per embryo transfer (FSH: 40% vs. FSH/hMG: 15%).
CONCLUSION(S): Because this study involved mostly women of advanced reproductive age, at least in such an age category, LH-containing stimulation causes adverse effects on pregnancy rates, although whether such an adverse effect on ploidy exists in parallel requires further investigation. These observations point toward embryo-independent adverse effects on implantation (luteal phase) in antagonist cycles with hMG costimulation.
DESIGN: Retrospective matched cohort study.
SETTING: Two academically affiliated private fertility centers, private preimplantation genetics laboratory, and medical school.
PATIENTS(S): One hundred four consecutive in vitro fertilization cycles (IVF) with preimplantation genetic diagnosis in women aged 30 to 45 years.
INTERVENTION(S): Antagonist cycles with ovarian stimulation by either recombinant follicle stimulating hormone (FSH) alone, or in combination with human menopausal gonadotropin (FSH/hMG).
MAIN OUTCOME MEASURE(S): After matching patients for age and gonadotropin dosage, embryo ploidy, pregnancy, and miscarriage rates were evaluated.
RESULT(S): Euploidy rates (FSH, 29.4% vs. FSH/hMG, 25.7%) and number of euploid embryos (FSH, 2.1 +/- 1.6 vs. FSH/hMG, 1.9 +/- 1.5) were similar between both groups, although trended in favor of FSH-only stimulation. FSH-only stimulation, however, demonstrated significantly higher clinical pregnancy rates per cycle start (FSH: 34.6% vs. FSH/hMG: 11.5%) and per embryo transfer (FSH: 40% vs. FSH/hMG: 15%).
CONCLUSION(S): Because this study involved mostly women of advanced reproductive age, at least in such an age category, LH-containing stimulation causes adverse effects on pregnancy rates, although whether such an adverse effect on ploidy exists in parallel requires further investigation. These observations point toward embryo-independent adverse effects on implantation (luteal phase) in antagonist cycles with hMG costimulation.