A comparison study of a novel stimulation protocol and the conventional low dose step-up and step-down regimens in patients with polycystic ovary syndrome undergoing in vitro fertilization.
OBJECTIVE
To compare the efficacy of a sequential step-up/step-down protocol with the conventional low dose step-up and the step-down regimens in patients with polycystic ovary syndrome (PCOS) undergoing IVF.


METHODS
Prospective randomized study.


METHODS
Private fertility clinic.


METHODS
Two hundred twenty-five, 30-year-old or younger, women with PCOS.


METHODS
The low dose step-up, the step-down, and a sequential step-up/step-down regimens were used.


METHODS
Ovarian response, pregnancy (PR) and miscarriage rate.


RESULTS
Patients in group A (low dose step-up) exhibited the highest cancellation rate, whereas subjects in group C (sequential regimen) the lowest. The hormonal dosage (ampules) and duration of stimulation (days) was higher in group A patients and lower in group B (step-down regimen). The follicular growth uniformity was superior in group C patients who also achieved a higher number of eggs at retrieval, better fertilization and embryo development rates. The sequential group yielded the highest pregnancy and the lowest miscarriage rate.


CONCLUSIONS
The sequential step-up/step-down stimulation protocol is superior to the low dose step-up and step-down regimens with regard to ovarian response, PR and miscarriage rate in 30-year-old or younger patients with PCOS undergoing IVF.
Koundouros
Savvas N
SN
The Genesis Centre for Fertility and Pre-Implantation Genetics, Nicosia, Cyprus. savvask1@spidernet.com.cy
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D015897:Comorbidity; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology* / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
D005640:Follicle Stimulating Hormone