Social Fertility Preservation - Does the Dosage and Protocol Matter?
2Infertility and IVF Unit, Barzilai University Medical Center, Israel
3Faculty of Health Sciences, Ben Gurion University of the Negev, Israel
4Sackler Faculty of Medicine, Tel Aviv University, Israel
Introduction:
During the last decade, social fertility preservation has become very popular, with approximally 20% of the IVF cycles performed in Israel are for that reason. Whether the starting dose, ovarian stimulation (OS) protocol or type of gonadotropins has an influence on the final number of oocytes retrieved are controversial. The aim of the study was to evaluate the impact of the OS characteristics on the outcome.
Patients and Methods:
We performed a cross sectional study including women who underwent two consecutive IVF cycles within 6 months for social fertility preservation. Data regarding patients’ demographic, clinical characteristics and the response to OS were collected from the computerized clinical files. The primary outcomes were number of retrieved oocytes and the number of mature oocytes.
Results:
The study included 430 patients who underwent two consecutive IVF cycles for social fertility preservation and were triggered with GnRH agonist 36 hours prior the ovum pickup. The initial FSH dosages (342±97 vs 389±100 IU, p<0.001) and total FSH dosages (3613±1357 vs. 3944±1390 IU, p<0.001) were significantly higher in the second cycle compared with the first cycle attempt. While the duration of OS was similar (10.5±1.9 vs. 10.2±1.7 days, p=0.3), peak estradiol levels (8647±5960 vs. 7596±4956 pmol/L, p=0.005) and the number of retrieved oocytes (11.2±6.9 vs. 9.4±6, p<0.001) and mature oocytes ( 8.7±5.2 vs. 7.3±4.4, p<0.001) were significantly higher in the second cycle compared with the first cycle.
Conclusion:
Increasing the daily gonadotropin dose beyond 300 IU/day improves the oocytes yield in social fertility preservation cycles.