title: MILD ovarian stimulation with GnRH-antagonist vs. long protocol with low dose FSH for non-PCO high responders undergoing IVF: a prospective, randomized study including thawing cycles.
abstract: OBJECTIVE
  To compare the effectiveness of two stimulation protocols in non-polycystic ovary (PCO) high responders undergoing in vitro fertilization (IVF).
  
  
  METHODS
  Prospective randomized trial.
  
  
  METHODS
  A Reproductive Medicine and IVF Unit of a University Hospital and a private IVF Clinic.
  
  
  METHODS
  Four hundred-and-twelve normoovulatory women with good ovarian responsiveness were randomized to receive either the "mild" (FSH 150 IU/day from day 4 of a spontaneous cycle followed by GnRH-antagonist from day 8; n = 205) or the "long" (FSH 150 IU/day; n = 207) stimulation protocol. The outcome of these two regimens was compared including "fresh" and thawing cycles.
  
  
  RESULTS
  The total FSH dose and the peak estradiol level were significantly lower in the "mild" protocol, whereas the retrieved oocytes, fertilization rate, number and quality of embryos, pregnancy and implantation rates, cumulative "fresh plus thaw" success rate, and incidence of severe ovarian hyperstimulation syndrome were comparable with the two regimens.
  
  
  CONCLUSIONS
  In young, normoovulatory patients with good ovarian responsiveness undergoing IVF the "mild" stimulation protocol has effectiveness and risks comparable to the "long" protocol with low FSH starting dose, even when thawing cycles are included in the comparison.
authors.affiliation: Physiopathology of Reproduction and IVF Unit, Department of Obstetrical and Gynecological Sciences, University of Torino, via Ventimiglia 3, 10126, Torino, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Casano
authors.forename: Daniela
authors.initials: D
authors.lastname: Guidetti
authors.forename: Ambra
authors.initials: A
authors.lastname: Patriarca
authors.forename: Giulia
authors.initials: G
authors.lastname: Pittatore
authors.forename: Gianluca
authors.initials: G
authors.lastname: Gennarelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Revelli
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000008:administration & dosage; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies
chemical_list: D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone