title: Is there a detrimental effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responders undergoing ART with long protocol?
abstract: BACKGROUND
  In recent years, it has become evident that ovarian stimulation, although a central component of in vitro fertilization (IVF), may itself has detrimental effects on oogenesis, embryo quality, endometrial receptivity, and perhaps also perinatal outcomes.
  
  
  OBJECTIVE
  To evaluate the effect of higher gonadotrophin dose on clinical pregnancy rate in normo-responder ICSI cycles with long protocol.
  
  
  METHODS
  A retrospective study was planned in the Department of Reproductive Endocrinology of Zekai Tahir Burak Women's Health Education and Research Hospital. 362 normo-responders undergoing ICSI cycles with long protocol were included in the study. Group 1 (n = 260): Total gonadotrophin dose <2198 IU and Group 2 (n = 102): Total gonadotrophin dose >2198 IU. Laboratory IVF outcome, clinical pregnancy rate were evaluated.
  
  
  RESULTS
  There was no statistically significant difference between peak estradiol levels, endometrial thickness, fertilization rates among the Group 1 versus Group 2 (p > 0.05). But there was a statistically significant difference in age, baseline FSH, oocyte number, 2PN, and clinical pregnancy among the Group 1 versus Group 2. Clinical pregnancy rate were significantly higher in Group 1 compared with Group 2 (p < 0.001). Lower gonadotrophin dose, 2PN was an independent positive predictor of clinical pregnancy (OR 2.65 for gonadotrophin dose, OR 1.1 for 2PN) CONCLUSION(S): Higher total gonadotrophin dose adversely affect clinical pregnancy in normo-responder patients undergoing ICSI cycles with long protocol.
authors.affiliation: Reproductive Endocrinology-IVF Department, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey. nafiyekarakas@gmail.com
authors.forename: Nafiye
authors.initials: N
authors.lastname: Yilmaz
authors.forename: Saynur
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Hasan
authors.initials: H
authors.lastname: Inal
authors.forename: Umit
authors.initials: U
authors.lastname: Gorkem
authors.forename: Berna
authors.initials: B
authors.lastname: Seckin
authors.forename: Ayten
authors.initials: A
authors.lastname: Turkkani
authors.forename: Cavidan
authors.initials: C
authors.lastname: Gulerman
mesh_terms: D015992:Body Mass Index; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006062:Gonadotropins / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage; D009865:Oocytes; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014421:Turkey
chemical_list: D006063:Chorionic Gonadotropin; D006062:Gonadotropins; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D016729:Leuprolide