title: Changing ovarian stimulation parameters in a subsequent cycle does not increase the number of euploid embryos.
abstract: OBJECTIVE
  To compare the euploidy outcome in patients that underwent 2 ovarian stimulation cycles with trophectoderm biopsy.
  
  
  METHODS
  Retrospective repeated-measures cohort study.
  
  
  METHODS
  University-based fertility center.
  
  
  METHODS
  A total of 116 patients, from 2011 through 2013, that underwent 2 ovarian stimulation cycles followed by trophectoderm biopsy with array comparative genomic hybridization.
  
  
  METHODS
  Days of stimulation, average diameter of the 2 lead follicles on day of trigger, dose of gonadotropins, type of cycle (gonadotropin-releasing hormone [GnRH] antagonist, GnRH-antagonist plus clomiphene citrate [CC], microdose GnRH agonist).
  
  
  METHODS
  Number of euploid embryos.
  
  
  RESULTS
  Patients were analyzed based on whether they had ≥1 euploid embryos in their first cycle vs. none. There was no increase in the number of euploid embryos with more days of stimulation or increases in the dose of gonadotropins in either group. Significantly more euploid embryos were seen in patients who had no euploid embryo(s) in the first cycle (Group 0) that had CC added to a GnRH-antagonist cycle (1.11 more euploid embryos) or were triggered when follicle sizes were 2 mm larger (0.40 euploid embryos), but these increases were not significant compared with a control group. Patients with euploid embryo(s) in the first cycle (Group 1) had significantly more euploid embryos when daily dose was increased by 75-149 international units, but this relationship was not significant compared with a control group with no increase in daily dose.
  
  
  CONCLUSIONS
  No specific intervention increased the number of euploid embryos within the same patient any more than simply repeating a similar stimulation cycle. An attempt was made to control for interpatient variability, but individual patients have considerable intercycle variability.
authors.affiliation: New York University Fertility Center, Langone Medical Center, New York University, New York, New York. Electronic address: hodesb01@med.nyu.edu.
authors.forename: Brooke
authors.initials: B
authors.lastname: Hodes-Wertz
authors.affiliation: New York University Fertility Center, Langone Medical Center, New York University, New York, New York.
authors.forename: David H
authors.initials: DH
authors.lastname: McCulloh
authors.affiliation: New York University Fertility Center, Langone Medical Center, New York University, New York, New York.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Berkeley
authors.affiliation: New York University Fertility Center, Langone Medical Center, New York University, New York, New York.
authors.forename: Jamie A
authors.initials: JA
authors.lastname: Grifo
mesh_terms: D000328:Adult; D001706:Biopsy; D002452:Cell Count; D055028:Comparative Genomic Hybridization; D004622:Embryo, Mammalian / Q000166:cytology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology; D054315:Oocyte Retrieval / Q000706:statistics & numerical data*; D010062:Ovulation Induction / Q000379:methods*; D011003:Ploidies; D011247:Pregnancy; D019836:Preimplantation Diagnosis; D012189:Retrospective Studies
keywords: Euploidy; array comparative genomic hybridization; controlled ovarian stimulation