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Research Paper | Obstetrics and Gynecology | India | Volume 12 Issue 5, May 2023
Does Gonadotropin Dosing during Ovarian Stimulation Influence the Quality of the Retrieved Ooctes
Dr. Jasmine Deva Arul Selvi .T | Dr. Kundavi Shankar [2] | Dr. Yamini Asokan [3] | Dr. Geetha .V | Dr. Rashmi [27] | Dr. Nithya N Naaram | Hema Nivedha
Abstract: Introduction: Ovarian stimulation during assisted reproductive technology (ART) cycles requires exogenous gonadotropins to allow for the retrieval of multiple oocytes which can be used for ART. The total gonadotropin dose used for ovarian stimulation is dependent on patient characteristics like age, BMI, ovarian reserve and responsiveness to follicular stimulating harmone (FSH). Hence, patients who are poor responders tend to receive higher doses. The success of in vitro fertilization (IVF) depends on both the number and the quality of retrieved oocytes. Aim: To analyse the association between the gonadotropin dose used for controlled ovarian stimulation and the quality of oocytes retrieved among the subfertile women. Method: In this retrospective study conducted in the department of Institute of Reproductive Medicine and women?s health, Madras Medical Mission hospital all subfertile women and oocytes donor between age group 21 ? 40 years who underwent In Vitro Fertilisation (IVF) treatment oocyte retrieval from 2019 to 2021 were included. Women with previously known poor quality oocytes, aged above 41 years were excluded. The study population was divided into three groups based on the gonadotropin dosage used for stimulation. Total gonadotropin dose refers to the total dose of FSH and human menopausal gonadotropin (hMG) preparations. Group 1: ? 3000 IU , Group 2: 3001 ? 4000 IU, Group 3: ? 4001 IU. Quality of oocytes assessed using 6 parameters creating a Total oocyte score (TOS) ranging between +6 to - 6. Results: Gonadotropins dose used for stimulation ranged between 1425 IU - 6300 IU. The duration of stimulation ranged between 8 - 13 days with an average of 10 days. There was statistically significant correlation between the duration of stimulation, gonadotropin dose and the quality of oocytes. Mean oocyte score in the group which received doses between 3001 - 3999 IU was 2.7 ? 1.1, which was higher than the score observed in groups which received less or more gonadotropins (Chart 10). At doses above 4000 IU the mean score was found to be less than 2 (i.e. 1.8 ? 1.4) Conclusion: Recruiting few oocytes that have the potential to fertilize and develop into a competent embryo with a high implantation capacity is the primary requirement, rather than striving for a more number of oocytes. Even in predicted poor responders ? starting with standard high dose of gonadotropins due to fear of cycle cancellation should be reconsidered. It is the quality which matters not the quantity.
Keywords: Gonadotropin dose, ovarian stimulation, oocyte quality, total oocyte score, mean oocyte score
Edition: Volume 12 Issue 5, May 2023,
Pages: 1208 - 1216