title: Controlled ovarian hyperstimulation interventions in infertile women aged 40 years or older undergoing in vitro fertilization.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Reproductive Medical Center, West China Second University Hospital, Sichuan University, Chengdu, China.
authors.forename: Lihong
authors.initials: L
authors.lastname: Geng
authors.forename: Weihong
authors.initials: W
authors.lastname: Li
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Li
authors.forename: Lang
authors.initials: L
authors.lastname: Qin
authors.forename: Zhun
authors.initials: Z
authors.lastname: Xiao
authors.forename: Shangwei
authors.initials: S
authors.lastname: Li
mesh_terms: 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
chemical_list: D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins