IMR Press / CEOG / Volume 44 / Issue 5 / DOI: 10.12891/ceog1957.2017

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Original Research
What is the best initial cycle IVF protocol for patients over 35 years old?
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1 Gazi University Department of Obstetrics and Gynecology, Ankara, Turkey
2 Cankiri Government Hospital, Department of Obstetrics and Gynecology Cankiri, Turkey
Clin. Exp. Obstet. Gynecol. 2017, 44(5), 721–725; https://doi.org/10.12891/ceog1957.2017
Published: 10 October 2017
Abstract

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.
Keywords
IVF hyperstimulation protocol
IVF outcome
Advanced age
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