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Low dose HP-hMG in an antagonist protocol for IVF in ovulatory and anovulatory patients with high AMH

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@article{9d4d5d48668943929f3078e03ec80e54,
title = "Low dose HP-hMG in an antagonist protocol for IVF in ovulatory and anovulatory patients with high AMH",
abstract = "Women with high-AMH levels have an increased risk of ovarian hyperstimulation syndrome (OHSS). Studies have suggested that highly purified menotropin (HP-hMG) Menopur{\circledR} reduces the risk. We, therefore, studied use of low-dose (112.5 IU/day) HP-hMG in ovulatory and anovulatory patients with high AMH (>32 pmol/L). The primary endpoint was the distribution of patients with appropriate, excessive, and inadequate response (5-14, ≥15, and ≤4 oocytes). Another endpoint was frequency of OHSS. Totally 115 women were included and 78 (67.8{\%}) had an appropriate, 8 (7.0{\%}) an excessive, and 29 (25.2{\%}) an inadequate response. The number of oocytes was independent on AMH levels and ovulatory status but declined significantly with increasing bodyweight (R2 = 0.07, p < .01). The ongoing pregnancy rate per started cycle was 47.0{\%}. Three (2.6{\%}) developed OHSS, two had cancelation of the cycle and seven patients had GnRH agonist triggering to prevent OHSS. Selective use of a low dose of HP-hMG in patients with high levels of AMH provides 5-14 oocytes in more than two-thirds of the patients and is safe with low risk of OHSS. The number of aspirated oocytes was independent of AMH levels and ovulatory status, but inversely related to body weight.",
keywords = "Adult, Anovulation/blood, Anti-Mullerian Hormone/blood, Dose-Response Relationship, Drug, Female, Fertilization in Vitro/methods, Gonadotropin-Releasing Hormone/antagonists & inhibitors, Hormone Antagonists/administration & dosage, Humans, Menotropins/administration & dosage, Ovarian Hyperstimulation Syndrome/prevention & control, Ovulation/blood, Ovulation Induction/methods, Pregnancy, Pregnancy Rate",
author = "Negjyp Sopa and Larsen, {Elisabeth Clare} and {Nyboe Andersen}, Anders",
year = "2018",
month = "7",
doi = "10.1080/09513590.2018.1428302",
language = "English",
volume = "34",
pages = "623--626",
journal = "Gynecological Endocrinology",
issn = "0951-3590",
publisher = "Informa Healthcare",
number = "7",

}

RIS

TY - JOUR

T1 - Low dose HP-hMG in an antagonist protocol for IVF in ovulatory and anovulatory patients with high AMH

AU - Sopa, Negjyp

AU - Larsen, Elisabeth Clare

AU - Nyboe Andersen, Anders

PY - 2018/7

Y1 - 2018/7

N2 - Women with high-AMH levels have an increased risk of ovarian hyperstimulation syndrome (OHSS). Studies have suggested that highly purified menotropin (HP-hMG) Menopur® reduces the risk. We, therefore, studied use of low-dose (112.5 IU/day) HP-hMG in ovulatory and anovulatory patients with high AMH (>32 pmol/L). The primary endpoint was the distribution of patients with appropriate, excessive, and inadequate response (5-14, ≥15, and ≤4 oocytes). Another endpoint was frequency of OHSS. Totally 115 women were included and 78 (67.8%) had an appropriate, 8 (7.0%) an excessive, and 29 (25.2%) an inadequate response. The number of oocytes was independent on AMH levels and ovulatory status but declined significantly with increasing bodyweight (R2 = 0.07, p < .01). The ongoing pregnancy rate per started cycle was 47.0%. Three (2.6%) developed OHSS, two had cancelation of the cycle and seven patients had GnRH agonist triggering to prevent OHSS. Selective use of a low dose of HP-hMG in patients with high levels of AMH provides 5-14 oocytes in more than two-thirds of the patients and is safe with low risk of OHSS. The number of aspirated oocytes was independent of AMH levels and ovulatory status, but inversely related to body weight.

AB - Women with high-AMH levels have an increased risk of ovarian hyperstimulation syndrome (OHSS). Studies have suggested that highly purified menotropin (HP-hMG) Menopur® reduces the risk. We, therefore, studied use of low-dose (112.5 IU/day) HP-hMG in ovulatory and anovulatory patients with high AMH (>32 pmol/L). The primary endpoint was the distribution of patients with appropriate, excessive, and inadequate response (5-14, ≥15, and ≤4 oocytes). Another endpoint was frequency of OHSS. Totally 115 women were included and 78 (67.8%) had an appropriate, 8 (7.0%) an excessive, and 29 (25.2%) an inadequate response. The number of oocytes was independent on AMH levels and ovulatory status but declined significantly with increasing bodyweight (R2 = 0.07, p < .01). The ongoing pregnancy rate per started cycle was 47.0%. Three (2.6%) developed OHSS, two had cancelation of the cycle and seven patients had GnRH agonist triggering to prevent OHSS. Selective use of a low dose of HP-hMG in patients with high levels of AMH provides 5-14 oocytes in more than two-thirds of the patients and is safe with low risk of OHSS. The number of aspirated oocytes was independent of AMH levels and ovulatory status, but inversely related to body weight.

KW - Adult

KW - Anovulation/blood

KW - Anti-Mullerian Hormone/blood

KW - Dose-Response Relationship, Drug

KW - Female

KW - Fertilization in Vitro/methods

KW - Gonadotropin-Releasing Hormone/antagonists & inhibitors

KW - Hormone Antagonists/administration & dosage

KW - Humans

KW - Menotropins/administration & dosage

KW - Ovarian Hyperstimulation Syndrome/prevention & control

KW - Ovulation/blood

KW - Ovulation Induction/methods

KW - Pregnancy

KW - Pregnancy Rate

U2 - 10.1080/09513590.2018.1428302

DO - 10.1080/09513590.2018.1428302

M3 - Journal article

VL - 34

SP - 623

EP - 626

JO - Gynecological Endocrinology

JF - Gynecological Endocrinology

SN - 0951-3590

IS - 7

ER -

ID: 56415280