COMPARISON OF POOR RESPONDERS WITH GOOD RESPONDERS USING A STANDARD BUSERELIN HUMAN MENOPAUSAL GONADOTROPIN REGIME FOR INVITRO FERTILIZATION

被引:124
作者
JENKINS, JM
DAVIES, DW
DEVONPORT, H
ANTHONY, FW
GADD, SC
WATSON, RH
MASSON, GM
机构
[1] University Department of Obstetrics and Gynaecology, Princess Anne and, BUPA Chalybeate Hospitals, Southampton
关键词
POOR RESPONSE; PITUITARY DOWN-REGULATION; BUSERELIN; INVITRO FERTILIZATION;
D O I
10.1093/oxfordjournals.humrep.a137459
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
This study identifies a group of 87 patients, who demonstrated a 'poor' response to a standard buserelin/human menopausal gonadotrophin (HMG) regime. The subsequent outcome in 61 of these 'poor' responders when treated with a higher dose of HMG to achieve a satisfactory response was compared with 250 patients, who showed a 'good' response to the standard regime. 'Poor' responders were significantly older than 'good' responders (P < 0.001), but no significant difference was demonstrated in the indication for in-vitro fertilization (IVF). Even on higher doses of HMG, 'poor' responders took longer for their follicles to achieve maturity than the 'good' responders (P < 0.01). 'Poor' responders produced 8.9 oocytes per oocyte collection compared to 11.8 in the 'good' responders (P < 0.01). The fertilization rate was significantly lower in the 'poor' responders compared to the 'good' responders (P < 0.01). Although there was no significant difference in morphometric grading between 'poor' responder embryos and 'good' responder embryos, the rate of cell division was significantly slower in embryos of the 'poor' responders than the 'good' responders (P < 0.01). The pregnancy rate per oocyte retrieval was 9% in the 'poor' responders compared to 29% in the 'good' responders (P < 0.01). The implantation rate in the 'poor' responders was 4.4% compared to 16.1% in the 'good' responders (P < 0.001).
引用
收藏
页码:918 / 921
页数:4
相关论文
共 18 条
  • [1] Alper M.M., Gamer P.R., Premature ovarian failure: Its relationship to autoimmune disease, Obstet. Gynecol, 66, pp. 27-30, (1985)
  • [2] Cameron I.T., O'Shea F.C., Rolland J.F., Hughes E.G., Dekretser D.M., Healey D.L., Occult ovarian failure: A syndrome of infertility, regular menses, and elevated follicle stimulating hormone concentrations, J. Clin. Endocrinol. Metab, 52, pp. 1193-1198, (1981)
  • [3] Chang Y.S., Kim S.H., Shin C.J., Moon S.Y., Lee J.Y., Controlled ovarianhyperstimulationwith GnRH agonist and FSH/HMG in the previous cancelled IVF patients, World Congress on Human Reproduction, (1990)
  • [4] Crosignani P.G., Ragni G., Lombroso G.C., Scarduelli C., De Lauretis A., Caccamo L.D., Dalpra L., Cavioni V., Cristani C., Wyssling H., Olivares M.D., IVF: Induction of ovulation in ‘poor’ responders, J. Steroid Biochem, 32, pp. 171-173, (1989)
  • [5] Diamond M., Pellicer A., Boyers S., Decherney A., The effect of periovarian adhesions on follicular development in patients undergoing ovarian stimulation for in-vitro fertilisation-embryo transfer, Fertil. Steril, 49, pp. 100-103, (1988)
  • [6] Dimfield M., Lejeune B., Camus M., Vekemans M., Leroy F., Growth rate of follicular oestrogen secretion in relation to the outcome of in vitro fertilisation and embryo replacement, Fertil. Steril, 43, pp. 379-384, (1985)
  • [7] Dlugi A.M., Laufer N., Decherney A.H., Maclusky N.J., Haseltine F.P., Polan M.L., Mezer H.C., Tarlatzis B., Naftolin F., The periovulatory and luteal phase of conception cycles following in vitro fertilisation and embryo transfer, Fertil. Steril, 41, pp. 530-537, (1984)
  • [8] Hofmann G.E., Toner J.P., Muasher S.J., Jones G.S., High dose follicle-stimulating hormone (FSH) ovarian stimulation in low- responder patients for in vitro fertilisation, J. in Vitro Fertil. Embryo Transfer, 6, pp. 285-289, (1989)
  • [9] Jenkins J.M., Davies D.W., Anthony F.W., Masson G.M., Gadd S.C., Watson R.H., The detrimental effect of functional ovarian cysts in buserelin/HMG IVF cycles, First International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists, (1990)
  • [10] Jones H.W., McDowell J., Acosta A., Sandow B., Rews M.C., Veeck L., Garcia J.E., Whibley T., Jones G.S., Wilkes C., Mantzavinos T., Wright G., The importance of the follicular phase to success and failure in in vitro fertilisation, Fertil. Steril, 40, pp. 317-321, (1983)