What is the best initial cycle IVF protocol for patients over 35 years old?


Celtemen P. T., Bozkurt N., Erdem M., Celtemen M. B., Erdem A., Oktem M., ...Daha Fazla

CLINICAL AND EXPERIMENTAL OBSTETRICS & GYNECOLOGY, cilt.44, sa.5, ss.721-725, 2017 (SCI-Expanded) identifier identifier

Özet

Purpose: The aim of this study was to find the most effective ovarian hyperstimulation protocol for patients over 35 years old. Materials and Methods: This is a retrospective study of 390 first IVF cycles of patients older than 35 years, that had serum follicle stimulating hormone < 10 IU/L, and that had no co-existing endocrine disorders. Long (n=181), antagonist (n=71), and micro-dose flare-up (n=138) protocols were evaluated. Results: Clinical pregnancy and live birth rates were highest in long protocol group and lowest in micro-dose protocol group. The difference between long and micro-dose protocol groups was statistically significant (p < 0.05). In multivariate logistic regression analysis, picked-up oocyte count (p = 0.005), endometrium thickness at hCG day (p = 0.006), age (p = 0.006), and antral follicle numbers (p = 0.013) were found to be predictive for obtaining clinical pregnancy. Treatment protocols were not found to be predictive for obtaining clinical pregnancy (p > 0.05). Conclusion: Treatment protocols were not found to be predictive for obtaining clinical pregnancy. Patient's age, antral follicle number, endometrial thickness at hCG day, and picked-up oocyte counts directly effect the pregnancy rates. Long protocol affects these factors positively can be preferred in younger patients with higher antral follicle numbers.