The rate of high ovarian response in women identified at risk by a high serum AMH level is influenced by the type of gonadotropin

Arce, Joan Carles; Klein, Bjarke M.; Marca, Antonio La

doi:10.3109/09513590.2014.892066

Cited by 20 publications

(15 citation statements)

References 54 publications

(45 reference statements)

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“…The two markers are strongly related to the quantitative aspect of ovarian reserve; hence a low AMH and/or AFC are highly indicative of possible low number of growing follicles and oocyte following ovarian stimulation. Moreover, both low AMH and AFC have been associated to reduced pregnancy and live birth following IVF independent of age [35][36][37][38][39][40][41]. This may indicate some relationship between quantity and quality of oocytes, with a The present study because of its retrospective design has relevant limitations, including a biased selection of women recruited for the study.…”

Section: Discussionmentioning

confidence: 85%

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study

Marca

Grisendi

Giulini

et al. 2015

J Assist Reprod Genet

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Purpose to compare the baseline characteristics and chance of live birth in the different categories of poor responders identified by the combinations of the Bologna criteria and establish whether these groups comprise a homogenous population. Methods database containing clinical and laboratory information on IVF treatment cycles carried out at the Mother-Infant Department of the University Hospital of Modena between year 2007 and 2011 was analysed. This data was collected prospectively and recorded in the registered database of the fertility centre. Eight hundred and thirty women fulfilled the inclusion/ exclusion criteria of the study and 210 women fulfilled the Bologna criteria definition for poor ovarian response (POR). Five categories of poor responders were identified by different combinations of the Bologna criteria. Results There were no significant differences in female age, AFC, AMH, cycle cancellation rate and number of retrieved oocytes between the five groups. The live birth rate ranged between 5.5 and 7.4 % and was not statistically different in the five different categories of women defined as poor responders according to the Bologna criteria. Conclusion The study demonstrates that the different groups of poor responders based on the Bologna criteria have similar IVF outcomes. This information validates the Bologna criteria definition as women having a uniform poor prognosis and also demonstrates that the Bologna criteria poor responders in the various subgroups represent a homogenous population with similar pre-clinical and clinical outcomes.

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Section: Discussionmentioning

confidence: 85%

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study

Marca

Grisendi

Giulini

et al. 2015

J Assist Reprod Genet

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“…The risk for OHSS may be reduced in women with high AMH levels who receive lower doses of gonadotropins for shorter periods (a mild stimulation protocol) (Anckaert et al, 2012;Nelson et al, 2007). Thus, the choice of an antagonist-controlled protocol (with mild stimulation doses) may minimize the frequency of cycle cancellations caused by OHSS in women with high AMH levels (Arce et al, 2014;Casano et al, 2012;Fauser et al, 2010;Hamdine et al, 2014;Nelson et al, 2007). Additionally, a recent analysis of two prospective, randomized trials comprising over 1400 assisted reproduction technique cycles indicated that selection of gonadotrophin, i.e.…”

Section: Amh: the Evidence As A Predictive Methodsmentioning

confidence: 97%

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

Fleming¹,

Seifer

Frattarelli³

et al. 2015

Reproductive BioMedicine Online

234

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“…Moreover, AMH has been identified as one of the best predictor of ovarian response in women undergoing ovarian stimulation with corifollitropin alfa in a GnRH antagonist protocol [16]. There is evidence that the type of gonadotropin may affect certain patients such as women at high risk of hyper-response or with PCOS [15,17].Our results indicate that the IVF protocol utilized is effective in terms of both clinical procedures and embryological parameters. The number of oocytes retrieved was regular as well as the maturity of the cells and the fertilization rate, suggesting the suitability of ovarian stimulation and ovulation induction.…”

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confidence: 60%

“…High basal concentrations of AMH have been associated with hyperresponse to gonadotropin stimulation [15]. Moreover, AMH has been identified as one of the best predictor of ovarian response in women undergoing ovarian stimulation with corifollitropin alfa in a GnRH antagonist protocol [16].…”

Section: Discussionmentioning

confidence: 99%

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The Use of Corifollitropin Alfa in Combination with a GnRH Analogue as Final Trigger in the Potential High Responders

Arnoldi¹

2014

JFIV Reprod Med Genet

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Background: A great concern exists in using corifollitropin alfa to induce ovarian stimulation in high responders due to the riskof OHSS.In this study, we utilized corifollitropin alfa in patients with the potential of being high responders, in addition to the GnRH analogue triptorelin, as final trigger to induce the oocyte maturation. An intensive luteal support was administered to allow the transfer in the same cycle. Patients and methods:Between January 2013 and September 2014, 35 patients were stimulated with corifollitropin alfa and underwent in vitro fertilization or intracytoplasmic sperm injection procedures. All women had levels of antimullerian hormone>3 ng/ml and antral follicle count >10 and <20. The patients with polycystic ovarian syndrome were excluded from the study. Results:The mean number of oocytes collected was 13.95 ± 6.04, the mean number of oocytes inseminated was 5.11 ± 1.66, the mean number of embryos obtained and transferred was 3.13 ±1.61 and 2.11 ± 0.92, respectively. All patients received a fresh embryo transfer,and the luteal phase was intensively supported by triptorelin and progesterone.A part of oocytes (2.47 ± 4.28) and blastocysts (0.39 ± 0.75) was vitrified.The clinical pregnancy was achieved in 15 patients and the ongoing pregnancy in11 women. Cumulative ongoing pregnancy rate, including the pregnancies achieved after thawing of eggs or embryos, was 39.47%. No OHSS were observed. Conclusions:Corifollitropin alfa plus triptorelin trigger elicits a safe ovarian stimulation in the potential high responderpatients. first day after insemination.Luteal phase was supportedby triptorelin 0.1 mg, one injection every other day from the embryo transfer, for a total of five injections. Additionally, 600 mg/day of micronized progesterone (Progeffik 200 mg, 3 cps/die) was started from the day of oocyte retrieval. A quantitative pregnancy test, done by dosing serum β-hCG, was performed 12 days after ovulation triggering with triptorelin and it was repeated 2 days later. In the presence of pregnancy, a transvaginal ultrasound was performed 28-32 days after the embryo transfer and repeated as required. Clinical pregnancy was confirmed if a fetal heartbeat was observed by transvaginal ultrasound. ResultsCharacteristics of ovarian stimulation and IVF/ICSI parameters are described in Table 1. Despite the patients included in this study had a high follicular response (14 women had over 15 oocytes retrieved), the ovarian stimulation protocol allowed to obtain a good fertilization rate and top-and good-quality embryos.Our results show that, in this group ofthe potential high responder patients, 15 clinical pregnancies and 11 ongoing pregnancies were achieved per fresh cycle ( Table 2). The cumulative ongoing pregnancy rate reached 39.47%, including 4 ongoing pregnancies which were obtained after the transfer of frozen-thawed oocyte (in one patient) and blastocysts (in three patients). Some of the pregnancies have already delivered the birth of a healthy baby. All patients reported good comp...

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The rate of high ovarian response in women identified at risk by a high serum AMH level is influenced by the type of gonadotropin

Cited by 20 publications

References 54 publications

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study

Live birth rates in the different combinations of the Bologna criteria poor ovarian responders: a validation study

Assessing ovarian response: antral follicle count versus anti-Müllerian hormone

The Use of Corifollitropin Alfa in Combination with a GnRH Analogue as Final Trigger in the Potential High Responders

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