Evaluation of the Impact of Letrozole in Combination with the GnRH Antagonist Ovarian Stimulation Protocol in Patients Expected to Have a Poor Ovarian Response (POSEIDON Groups 3 and 4)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
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- Female age exceeding 44 years;
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- Absence of fresh embryo transfer;
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- Presence of structural uterine abnormalities diagnosed via ultrasonography or hysterosalpingography (e.g., dysmorphic uterus, intrauterine adhesions);
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- Presence of endocrinological disorders (e.g., diabetes, hyperprolactinemia, thyroid disorders) requiring medication;
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- History of recurrent pregnancy loss;
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- Use of add-ons other than letrozole during ovarian stimulation;
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- Male factor infertility attributed to azoospermia.
2.2. ART Treatment Protocol
2.3. Outcome Measures
2.4. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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GnRH-ant Group (n = 281) | GnRH-LZ Group (n = 168) | p | |
---|---|---|---|
Age (years) | 34.9 ± 5.1 | 36.4 ± 4.9 | 0.002 |
Duration of infertility (years) | 5.9 ± 5.1 | 7.5 ± 5.8 | 0.004 |
Number of previous IVF/ICSI treatments | 1.1 ± 1.4 | 1.5 ± 1.8 | 0.028 |
Basal FSH (mIU/mL) | 11.9 ± 7.5 | 13.7 ± 8.4 | 0.022 |
Basal estradiol (pg/mL) | 57.6 ± 60.6 | 52.7 ± 46.5 | 0.338 |
AMH (ng/mL) | 0.66 ± 0.5 | 0.56 ± 0.6 | 0.154 |
AFC, no. | 3.9 ± 1.8 | 3.7 ± 1.8 | 0.006 |
Duration of ovarian stimulation (days) | 11.2 ± 3.9 | 10.2 ± 3 | 0.005 |
Total dose of gonadotropins (IU) | 3108.9 ± 1075.6 | 2661.3 ± 1284.5 | <0.001 |
EMT on the day of trigger (mm) | 10.4 ± 8.2 | 9.7 ± 1.8 | 0.247 |
Peak estradiol level (pg/mL) | 913.4 ± 603.1 | 477.5 ± 487.9 | <0.001 |
Number of follicles ≥ 17 mm on the day of trigger | 2 ± 1.3 | 2.2 ± 1.5 | 0.199 |
Number of oocytes retrieved | 2.7 ± 2 | 2.5 ± 2 | 0.399 |
Number of MII oocytes | 2 ± 1.8 | 1.8 ± 1.4 | 0.198 |
Number of 2PN embryos | 1.3 ± 1.2 | 1.3 ± 1.1 | 0.974 |
Number of high-quality embryos | 0.5±0.8 | 0.4 ± 0.7 | 0.171 |
Number of transferred embryos | 0.8 ± 0.7 | 1 ± 0.7 | 0.053 |
Fertilization rate, % | 58.9 | 66.3 | 0.051 |
Implantation rate, % | 13.3 | 8.3 | 0.066 |
POSEIDON 3 | p | POSEIDON 4 | p | |||
---|---|---|---|---|---|---|
Outcome Parameter (Per Cycle) | GnRH-ant (n = 121) | GnRH-LZ (n = 56) | GnRH-ant (n == 160) | GnRH-LZ (n = 112) | ||
Clinical pregnancy rate | 20 (16.4%) | 8 (14.3%) | 0.703 | 27 (16.9%) | 11 (9.8%) | 0.098 |
Miscarriage rate | 6 (4.9%) | 1 (1.8%) | 0.313 | 10 (6.3%) | 3 (2.7%) | 0.174 |
Live birth rate | 14 (11.6%) | 7 (12.7%) | 0.858 | 17 (10.6%) | 8 (7.1%) | 0.327 |
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Varlı, B.; Şükür, Y.E.; Özdemir, E.Ü.; Özmen, B.; Sönmezer, M.; Berker, B.; Atabekoğlu, C.; Aytaç, R. Evaluation of the Impact of Letrozole in Combination with the GnRH Antagonist Ovarian Stimulation Protocol in Patients Expected to Have a Poor Ovarian Response (POSEIDON Groups 3 and 4). Medicina 2024, 60, 407. https://doi.org/10.3390/medicina60030407
Varlı B, Şükür YE, Özdemir EÜ, Özmen B, Sönmezer M, Berker B, Atabekoğlu C, Aytaç R. Evaluation of the Impact of Letrozole in Combination with the GnRH Antagonist Ovarian Stimulation Protocol in Patients Expected to Have a Poor Ovarian Response (POSEIDON Groups 3 and 4). Medicina. 2024; 60(3):407. https://doi.org/10.3390/medicina60030407
Chicago/Turabian StyleVarlı, Bulut, Yavuz Emre Şükür, Eda Üreyen Özdemir, Batuhan Özmen, Murat Sönmezer, Bülent Berker, Cem Atabekoğlu, and Ruşen Aytaç. 2024. "Evaluation of the Impact of Letrozole in Combination with the GnRH Antagonist Ovarian Stimulation Protocol in Patients Expected to Have a Poor Ovarian Response (POSEIDON Groups 3 and 4)" Medicina 60, no. 3: 407. https://doi.org/10.3390/medicina60030407