Document Detail


The reproductive outcome following a superhigh response to stimulation in gamete intrafallopian transfer program.
MedLine Citation:
PMID:  1753165     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A retrospective analysis was carried out to assess the outcome of gamete intrafallopian transfer (GIFT) in cycles when more than 10 oocytes were retrieved (superhigh responders) from October 1987 through June 1989. There were 276 (13%) cycles with more than 10 oocytes retrieved among all GIFT cycles initiated during the period. Clomiphene citrate and gonadotropin were employed for ovarian stimulation in 105 (38%) cycles, and gonadotropin releasing hormone agonist in the remaining 171 (62%) cycles, employing either the flare (104 cycles) or the pituitary down-regulation (67 cycles) protocol. A maximum number of four oocytes was transferred per GIFT (3.5 +/- 0.4). The mean number of oocytes retrieved was 14.7 +/- 4.4 (range, 11 to 35). A significantly younger age group (less than 30 years) of patients was noticed in the study (31.9), and fewer women aged 40 and over (6.2%), compared to the general population of our patients. The pregnancy rate was 33.3% (n = 92) per cycle, with a delivery rate of 23.6% (n = 64) per cycle; the pregnancy loss rate was 30.8%. The reproductive outcome was lower in women aged 40 and over (pregnancy rate was 23.5%, but delivery rate was only 5.8% per cycle). The delivery rate was lower in the clomiphene citrate- and gonadotropin-stimulated cycles (51.7% per pregnancy) in relation to gonadotropin-releasing analogue and gonadotropin cycles (76.6% per pregnancy) and significantly so compared with the pituitary down-regulation protocol (83.3% per pregnancy). We conclude that a superhigh response develops more in younger women, and in such circumstances, the use of pituitary down-regulation with gonadotropin-releasing hormone will improve the reproductive outcome.
Authors:
T al-Shawaf; A Nolan; P Nadkarni; J Harper; J Brown; R Guirgis; G Emerson; M Bayly; I Craft
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of in vitro fertilization and embryo transfer : IVF     Volume:  8     ISSN:  0740-7769     ISO Abbreviation:  J In Vitro Fert Embryo Transf     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1992-01-30     Completed Date:  1992-01-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8412594     Medline TA:  J In Vitro Fert Embryo Transf     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  202-7     Citation Subset:  IM    
Affiliation:
London Fertility Centre, U.K.
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MeSH Terms
Descriptor/Qualifier:
Adult
Buserelin / therapeutic use
Clomiphene / therapeutic use
Embryo Transfer
Female
Gamete Intrafallopian Transfer*
Humans
Menotropins / therapeutic use
Ovulation Induction / methods
Pregnancy
Pregnancy Outcome*
Retrospective Studies
Superovulation*
Chemical
Reg. No./Substance:
57982-77-1/Buserelin; 61489-71-2/Menotropins; 911-45-5/Clomiphene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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