Gonadotropin dose is negatively correlated with live birth rate: analysis of more than 650,000 assisted reproductive technology cycles.
OBJECTIVE
To evaluate the correlation between total gonadotropin dose and live birth rate.


DESIGN
Retrospective analysis.


SETTING
Not applicable.


PATIENT(S)
A total of 658,519 fresh autologous cycles of in vitro fertilization (IVF) reported to the Society for Assisted Reproductive Technology from 2004 to 2012.


INTERVENTION(S)
None.


MAIN OUTCOME MEASURE(S)
Logistic regression models were fitted to live birth rates with the use of categorized values for total FSH dose and number of oocytes retrieved as the primary predictor variables. To reduce the effect of the most significant confounders that may lead physicians to prescribe higher doses of FSH, additional analyses were performed limited to good-prognosis patients (<35 years of age, body mass index <30 kg/m(2), and no diagnosis of diminished ovarian reserve, endometriosis, or ovulatory disorder) and including duration of gonadotropin treatment.


RESULT(S)
Live birth rate significantly decreased with increasing FSH dose, regardless of the number of oocytes retrieved. The statistically significant decrease in live birth rate with increasing FSH dose remained in patients with good prognosis, and regardless of female age, except for women aged ≥ 35 years with 1-5 oocytes retrieved.


CONCLUSION(S)
This analysis suggests that physicians may wish to avoid prescribing a high dose of FSH. However, the results of this study do not justify the use of minimal-stimulation or natural-cycle IVF.
['Baker|Valerie L|VL|', 'Brown|Morton B|MB|', 'Luke|Barbara|B|', 'Smith|George W|GW|', 'Ireland|James J|JJ|']
D000328:Adult D000367:Age Factors D015992:Body Mass Index D016208:Databases, Factual D004305:Dose-Response Relationship, Drug D005260:Female D005300:Fertility Agents, Female D005307:Fertilization in Vitro D005640:Follicle Stimulating Hormone D006801:Humans D007246:Infertility D050498:Live Birth D016015:Logistic Models D054315:Oocyte Retrieval D010062:Ovulation Induction D011247:Pregnancy D018873:Pregnancy Rate D012189:Retrospective Studies D012307:Risk Factors D016896:Treatment Outcome
gonadotropin dose live birth rate In vitro fertilization