title: Comparison of FSH and hMG on ovarian stimulation outcome with a GnRH antagonist protocol in younger and advanced reproductive age women.
abstract: OBJECTIVE
  To compare the embryo outcomes of in vitro fertilization/intra-cytoplasmic sperm injection with a gonadotropin-releasing hormone (GnRH) antagonist protocol with follicle stimulating hormone (FSH) and with human menopausal gonadotropin (hMG).
  
  
  METHODS
  We performed a retrospective cohort study in 465 patients. Stimulation was started by daily FSH injection, and either FSH was continued (FSH alone group) or hMG was administrated (FSH-hMG group) after administration of a GnRH antagonist. Primary outcomes were the embryo profile (number of retrieved, mature, and fertilized eggs, and morphologically good embryos on day 3) and endocrine profile. Secondary outcomes were the doses and durations of gonadotropin. Data were stratified by the patients' age into two groups: <35 years and ≥35 years.
  
  
  RESULTS
  In patients aged <35 years, the number of retrieved oocytes in the FSH alone group was significantly increased than that in the FSH-hMG group (13.7 vs 9.2,P= 0.04), while there was no difference at other age groups. The FSH-hMG group required a significantly greater amount of gonadotropins at any age (all ages,P< 0.001; <35 years,P= 0.013; ≥35 years,P< 0.001).
  
  
  CONCLUSIONS
  Exogenous FSH alone is probably sufficient for follicular development and hMG may not improve the embryo profile in a GnRH antagonist protocol across all age.
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Chisa
authors.initials: C
authors.lastname: Tabata
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Miki
authors.initials: M
authors.lastname: Sugawa
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Momo
authors.initials: M
authors.lastname: Noma
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Onoue
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Kusumi
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Watanabe
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Kurosawa
authors.affiliation: Sanno Hospital, Center of Reproduction and Gynecologic Endoscopic Surgery, 8-10-16 Akasaka Minatoku, Tokyo Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Tsutsumi
keywords: Embryo profile; Endocrine profile; FSH; GnRH Antagonist; hMG