Controlled ovarian hyperstimulation interventions in infertile women aged 40 years or older undergoing in vitro fertilization.
BACKGROUND
The success of in vitro fertilization (IVF) treatment depends on adequate follicle recruitment following controlled ovarian hyperstimulation (COH). Women aged 40 years or older have a reduced ovarian reserve and various treatment protocols have been proposed that aim to increase their ovarian response.


OBJECTIVE
To compare the effectiveness of different COH treatment interventions in women undergoing IVF aged 40 years or older.


METHODS
MEDLINE, the Cochrane Library, and the Chinese Biomedical database were searched for randomized controlled trials (RCTs).


METHODS
Only RCTs comparing one type of COH intervention with another in women undergoing IVF aged 40 years or older were included.


METHODS
Two authors independently searched the abstracts, identified relevant papers, assessed inclusion and trial quality, and extracted the relevant data.


RESULTS
Four trials involving 4 different comparison groups were included in the review and enrolled a total of 611 randomized subjects.


CONCLUSIONS
There was insufficient evidence to support the routine use of any particular COH intervention to manage infertile women aged 40 years or older undergoing IVF. More robust data from good quality RCTs with relevant outcomes are needed.
Geng
Lihong
L
Department of Obstetrics and Gynecology, Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, China.
Li
Weihong
W
Li
Xiaohong
X
Qin
Lang
L
Xiao
Zhun
Z
Li
Shangwei
S
D000328:Adult; D000367:Age Factors; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008596:Menotropins / Q000008:administration & dosage; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D016032:Randomized Controlled Trials as Topic; D013480:Superovulation
D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins