Clinics (Sao Paulo, Brazil) · 2026
Effectiveness of a low-dose gonadotropin protocol for controlled ovarian stimulation at a University Assisted Reproduction Center.
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Nakano Mayra Satiko Lemos, Baracat Edmund Chada, Júnior José Maria Soares, Fazão Henrique Penna, Bonetti Tatiana Carvalho de Souza, Monteleone Pedro Augusto Araújo
Аннотация
OBJECTIVE: This study evaluates the effectiveness of a low-dose gonadotropin protocol for Controlled Ovarian Stimulation (COS) in In Vitro Fertilization (IVF) for patients with a good prognosis attending a public health university care center.
STUDY DESIGN: A randomized, non-inferiority, single-blind clinical trial. This study included 90 couples undergoing IVF cycles. Patients were randomized to receive either the regular-dose (REG-DOSE, n = 46) or low-dose (LOW-DOSE, n = 44) gonadotropin protocol. The REG-DOSE group received menotropin (225 IU/day), while the LOW-DOSE group received the combination of clomiphene citrate (Clomid®) and menotropin (150 IU/day). The primary outcome was the number of blastocysts available for transfer.
RESULTS: The REG-DOSE and LOW-DOSE groups had similar blastocyst development rates (49.9% and 54.8%; p = 0.463). The secondary outcomes measured, such as ongoing pregnancy rates after the first embryo transfer (23.7% and 26.5%; p = 0.729) and the cumulative clinical pregnancy rates (34% and 30%; p = 0.726), respectively, were also comparable.
CONCLUSIONS: Results provide strong evidence that low-dose gonadotropin protocols for COS in good prognosis IVF patients yield comparable clinical outcomes to regular-dose protocols, with the added benefit of reduced treatment costs. These results support the clinical equivalence of low-dose protocols in selected patients and highlight their potential to reduce costs and increase access to IVF, particularly in public healthcare systems.
STUDY DESIGN: A randomized, non-inferiority, single-blind clinical trial. This study included 90 couples undergoing IVF cycles. Patients were randomized to receive either the regular-dose (REG-DOSE, n = 46) or low-dose (LOW-DOSE, n = 44) gonadotropin protocol. The REG-DOSE group received menotropin (225 IU/day), while the LOW-DOSE group received the combination of clomiphene citrate (Clomid®) and menotropin (150 IU/day). The primary outcome was the number of blastocysts available for transfer.
RESULTS: The REG-DOSE and LOW-DOSE groups had similar blastocyst development rates (49.9% and 54.8%; p = 0.463). The secondary outcomes measured, such as ongoing pregnancy rates after the first embryo transfer (23.7% and 26.5%; p = 0.729) and the cumulative clinical pregnancy rates (34% and 30%; p = 0.726), respectively, were also comparable.
CONCLUSIONS: Results provide strong evidence that low-dose gonadotropin protocols for COS in good prognosis IVF patients yield comparable clinical outcomes to regular-dose protocols, with the added benefit of reduced treatment costs. These results support the clinical equivalence of low-dose protocols in selected patients and highlight their potential to reduce costs and increase access to IVF, particularly in public healthcare systems.