Azalmış Over Rezervinin İn Vitro Fertilizasyon Sonucu Üzerindeki Etkileri

Year 2023, , 315 - 318, 20.12.2023

Özlem Kara , İdil Duran

https://doi.org/10.46332/aemj.1251573

Abstract

Amaç: Biz bu çalışmada mikrodoz ve antagonist rejimlerin IVF-ICSI sonucu üzerindeki etkilerini karşılaştırmayı amaçladık.

Araçlar ve Yöntem: Çalışma 2018-2022 yılları arasında Maltepe Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesi Tüp Bebek Kliniği'nde gerçekleştirildi. Hastaların dosyaları retrospektif olarak incelendi ve yaş, infertilite süresi, bazal FSH düzeyi, vücut kitle indeksi, antral folikül sayısı (AFC), antimüllerian hormon (AMH) düzeyi, toplanan oosit sayısı, metafaz 2 oosit sayısı, fertilizasyon ve gebelik oranları değerlendirildi. Grup 1'deki hastalara (n=124) gonadotropin releasing hormon (GnRH) mikrodoz protokolü, Grup 2'deki (n=136) hastalara ise antagonist protokol uygulandı.

Bulgular: Hastaların yaş, infertilite süresi, bazal FSH düzeyi vücut kitle indeksi, AFC ve AMH düzeyi gibi parametreler açısından gruplar arasında anlamlı fark yoktu (p>0.05). Elde edilen oosit sayısı, metafaz 2 oosit sayısı, fertilizasyon oranları ve gebelik oranları da benzerdi (p>0.05).

Sonuç: Bizim sonuçlarımız, mikrodoz ve antagonist rejimlerin zayıf yanıt veren kadınlarda IVF-ICSI sonucu üzerinde benzer etkiye sahip olduğunu göstermiştir.

Keywords

In vitro fertilizasyon, zayıf yanıt veren, gebelik, mikrodoz protokol, antagonist rejim

Supporting Institution

Yok

The Efficacy of Decreased Ovarian Reserve on in Vitro Fertilization Outcome

Abstract

Purpose: In this study, we aimed to compare the effects of microdose and antagonist regimens on IVF-ICSI outcome.

Materials and Methods: The study was conducted at the Maltepe University Medical Faculty Training and Research Hospital IVF Clinic during the period of 2018 and 2022. The files of the patients were reviewed retrospectively and age, duration of infertility, basal FSH level, body mass index, antral follicle number (AFC), antimullerian hormon (AMH) level, retrieved oocyte number, metaphase 2 oocyte number, fertilization and pregnancy rates were evaluated. The patients in Group 1 (n=124) were treated by using gonadotropin releasing hormone (GnRH) microdose protocol and in Group 2 (n=136) were treated by using antagonist protocol.

Results: There was no significant difference between the groups in terms of the characteristics of the patients such as age, infertility duration, basal FSH level body mass index, AFC and AMH level (p>0.05). The retrieved oocyte number, metaphase 2 oocyte number, fertilization rates and pregnancy rates were also similar (p>0.05).

Conclusion: Our results demonstrated that microdose and antagonist regimens have similar effect in poor reponder women on IVF-ICSI outcome.

Keywords

antagonist regimen, ın vitro fertilization, microdose protocol, poor responder, pregnancy

References

• 1. Definitions of infertility and recurrent pregnancy loss. Fertil Steril. 2008;90(5):60.
• 2. Gnoth, C., Infertility: definitions and strategies. Minerva Ginecol. 2012;64(1):31-39.
• 3. Kara M, Aydın T, Aran T, Turktekin N, Ozdemir B. Does dehydroepiandrosterone supplementation really affect IVF-ICSI outcome in women with poor ovarian reserve? Eur J Obstet Gynecol Reprod Biol. 2014;173:63-65.
• 4. Kara M, Sofuoglu K, Kutlu T, Devranoglu B, Cetinkaya T. Comparison of the Efficacy and Cost-effectiveness of Highly Purified Urinary Follicle Stimulating Hormone (HP-uFSH) and Recombinant Follicle Stimulating Hormone (rFSH) in Poor Responders. J. Dow Univ. Health Sci. 2011;5(2):43-46.
• 5. De Placido G, Mollo A, Alviggi C, et al. Rescue of IVF cycles in pituitary down regulated normogonadothtopic young women characterized by a poor initial response to recombinant FSH. Hum Reprod 2001;16(9):1875-1879.
• 6. Ubaldi F, Rienzi L, Ferrero S et al. 2005 Management of poor responders in IVF. Reproductive Bio Medicine Online. 2005;10(2):235-246.
• 7. Demirol A, Gurgan T. Comparison of microdose flare-up and antagonist multiple dose protocols for poor responder patients: a randomized study. Fertil Steril. 2009;92(2):481-485.
• 8. Gleicher, N., V.A. Kushnir, and D.H. Barad, Prospectively assessing risk for premature ovarian senescence in young females: a new paradigm. Reprod Biol Endocrinol. 2015;13(1):34.
• 9. Fritz, MA., Speroff L. Clinical gynecologic endocrinology and infertility. 2014. lippincott Williams & wilkins.
• 10. Roseboom TJ, Vermeiden JP, Schoute E. et al. 1995 The probability of pregnancy after ET is affected by the age of the patient, cause of infertility, number of embryos transferred and the average morphology score, as revealed by multiple logistic regression analysis. Human Reprod. 1995;10(11):3035-3041.
• 11. Kara M, Aydın T, Aran T, Turktekin N, Ozdemir B. Comparison of GnRH agonist and antagonist protocols in normoresponder patients who had IVF-ICSI. Arch Gynecol Obstet. 2013;288:1413-1416.
• 12. Kara M, Kutlu T, Sofuoglu K. Comparison of the Recombinant Versus Highly-Purified, Urinary Follicle-Stimulating Hormone (r-FSH vs. HP-uFSH) in the Polycystic Ovary Syndrom Patients who had Antagonist Cycle with In Vitro Fertilization-Embryo Transfer. Turkiye Klinikleri J Med Sci. 2011;31(4):775-779.
• 13. Land JA, Yarmolinskaya MI, Dumoulin JC et al. High-dose HMG stimulation in poor responders does not improve IVF outcome. Fertil Steril. 1996;65(5):961-965.
• 14. Kahraman K, Berker B, Atabekoglu CS, et al. Microdose gonadotropin releasing hormone agonist flare-up protocol versus multiple dose gonadotropin releasing hormone antagonist protocol in poor responders undergoing intracytoplasmic sperm injection embryo transfer cycle. Fertil Steril. 2009;91(6):2437-2444.
• 15. Scott RT, Navot D. Enhancement of ovarian responsiveness with microdoses of gonadotropin-releasing hormone agonist during ovulation induction for in vitro fertilization. Fertil Steril. 1994;61(5):880-885.
• 16. Surrey ES, Bower J, Hill DM, Ramsey J, Surrey MW. Clinical and endocrine effects of a microdose GnRH agonist flare regimen administered to poor responders who are undergoing in vitro fertilization. Fertil Steril. 1998;69(3):419-424.
• 17. Nikolettos N, Al-Hasani S, Felberbaum R, et al. Gonadotropin-releasing hormone antagonist protocol: a novel method of ovarian stimulation in poor responders. Eur J Obstet Gynecol Reprod Biol 2001;97(2):202-207.
• 18. Mahutte MG, Arici A. Role of gonadotropin-releasing hormone antagonists in poor responders. Fertil Steril. 2007;87(2):241-249.
• 19. Akman M, Erden H, Tosus S, Bayazıt N, Aksoy E, Bahceci M. Comparison of agonistic flare-up protocol and antagonistic multiple dose protocol in ovarian stimulation of poor responders: results of a prospective randomized trial. Hum Reprod. 2001;16(5):868-870.