title: [High doses of gonadotropins for controlled ovarian hyperstimulation: A case-control study].
abstract: OBJECTIVE
  While assisted reproductive technology (ART) activity increases throughout the world, most teams have to face with the challenge of ovarian stimulation in poor responders. Despite a huge amount of literature available, no consensus currently exists on the best protocol, molecule or dose to use in these patients. The main objective of this case-control study was to compare ovarian stimulation and IVF outcome in patients at risk of poor ovarian response undergoing antagonist protocol with high doses of gonadotropins (≥450IU/day) versus patients undergoing stimulation at 300IU/day.
  
  
  METHODS
  This retrospective monocentric study was conducted in 2013 on antagonist cycles performed with ≥450IU/day. Each cycle was matched with a control antagonist cycle with 300IU/day injection, with strict matching for ART type, age, serum anti-müllerian hormone (AMH) and body mass index (BMI).
  
  
  RESULTS
  A total of 82 high dose cycles were matched and compared with 82 control cycles. Both groups were comparable, except for poor responder prevalence and mean IVF rank, which were higher in high dose group than in control group. No significant difference was observed between the groups in terms of number of oocytes, embryos, fertilization rate, implantation and ongoing pregnancy rates.
  
  
  CONCLUSIONS
  No ovarian stimulation protocol has demonstrated its superiority in expected poor responders up to now, especially regarding doses of gonadotropins to use. Accordingly, our study did not show any difference between high dose stimulation regimen (≥450IU/day) and conventional stimulation (300IU/day) in terms of IVF cycle outcome.
authors.affiliation: Service de gynécologie obstétrique, CHD de La Roche-sur-Yon, Les Oudairies, 85925 La Roche-sur-Yon cedex 9, France; Centre AMP Procrealis, 11, boulevard René-Levesque, BP 669, 85016 La Roche-sur-Yon cedex, France; Service de médecine et biologie du développement et de la reproduction, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France. Electronic address: marinedercourt@hotmail.fr.
authors.forename: M
authors.initials: M
authors.lastname: Dercourt
authors.affiliation: Service de médecine et biologie du développement et de la reproduction, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France; Faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; Inserm UMR 1064, CHU de Nantes, immeuble Jean-Monnet, 30, boulevard Jean-Monnet, 44093 Nantes cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Barriere
authors.affiliation: Service de médecine et biologie du développement et de la reproduction, CHU de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes cedex 1, France; Faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; Inserm UMR 1064, CHU de Nantes, immeuble Jean-Monnet, 30, boulevard Jean-Monnet, 44093 Nantes cedex 1, France; Clínica Eugin, Travessera de les Corts, 08029 Barcelona, Espagne.
authors.forename: T
authors.initials: T
authors.lastname: Freour
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000008:administration & dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D005640:Follicle Stimulating Hormone
keywords: Antagonist protocol; FIV; Fortes doses de gonadotrophines; High doses of gonadotropins; IVF; Mauvaises répondeuses; Ovarian stimulation; Poor responder; Protocole antagoniste; Stimulation ovarienne