title: Efficacy and safety of late-start Corifollitropin-alfa administration for controlled ovarian hyperstimulation in IVF: a cohort, case-control study.
abstract: OBJECTIVE
  To investigate efficacy and safety of a controlled ovarian stimulation (COS) protocol in which a single dose of Corifollitropin-alfa (CFα) was administered on day 4 of a GnRH-antagonist cycle.
  
  
  METHODS
  Cohort case-control study.
  
  
  METHODS
  University Hospital.
  
  
  METHODS
  One hundred twenty-two normally cycling women expected to be normal responders to COS.
  
  
  METHODS
  In 61 patients, CFα (100-150 μg) was injected subcutaneously on day 4 of a spontaneous menstrual cycle; a GnRH-antagonist was added from day 8 (fixed protocol; 0.25 mg/day). If needed to complete follicular maturation, recombinant FSH (rFSH) daily injections (150/200 IU/day) were given from day 11. A control group of 61 matched women was stimulated with daily subcutaneous injections of rFSH (100-150 U/day) from day 4 of the cycle, and received GnRH-antagonist (0.25 mg/day) from day 8. IVF or ICSI was performed according to the sperm characteristics, and 1-2 embryos were transferred in utero under US guidance on day 2.
  
  
  METHODS
  Number of retrieved cumulus-oocyte complexes (COCs), clinical pregnancy rate (PR), implantation rate (IR), ongoing PR at 10 weeks, number of injections/cycle, ovarian hyperstimulation syndrome (OHSS) rate.
  
  
  RESULTS
  No cycle was cancelled and the mean number of retrieved COCs was comparable in patients and controls. About 60% of CF-alfa treated women had no need of daily rFSH addition, and the mean number of injections/cycle was significantly lower in the CF-alfa group than in controls (p < 0.05). The ongoing PR/transfer was 36.8% in CF-alfa group and 37.5% in controls. No patient developed severe OHSS, and the incidence of moderate OHSS was similar in cases and controls.
  
  
  CONCLUSIONS
  CFα may be started on day 4 of the cycle obtaining results comparable to those of a COS using day 4-start daily rFSH, with significantly less injections and a similar risk of OHSS.
authors.affiliation: Gynecology and Obstetrics I, Physiopathology of Reproduction and IVF Unit, S. Anna Hospital, Department of Surgical Sciences, University of Torino, Torino, Italy, AERRE99@YAHOO.COM.
authors.forename: Alberto
authors.initials: A
authors.lastname: Revelli
authors.forename: Giulia
authors.initials: G
authors.lastname: Pittatore
authors.forename: Simona
authors.initials: S
authors.lastname: Casano
authors.forename: Stefano
authors.initials: S
authors.lastname: Canosa
authors.forename: Francesca
authors.initials: F
authors.lastname: Evangelista
authors.forename: Chiara
authors.initials: C
authors.lastname: Benedetto
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005307:Fertilization in Vitro / Q000187:drug effects*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000473:pathology; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D043373:Follicle Stimulating Hormone, Human; C437186:follicle stimulating hormone, human, with HCG C-terminal peptide; D005640:Follicle Stimulating Hormone