Authors: V S Vanni P Viganò L Quaranta L Pagliardini P Giardina M Molgora M Munaretto M Candiani E Papaleo
Publish Date: 2016/08/27
Volume: 40, Issue: 1, Pages: 69-75
Abstract
Premature luteinization of one or more developing follicles complicates 1–2 of controlled ovarian stimulation cycles for assisted reproduction The management of this complication is controversial with cycle cancellation likely representing the most commonly used strategy The aim of this study was to evaluate the efficacy of the “freezeall” policy—where the entire cohort of blastocysts is cryopreserved for subsequent frozenthawed embryo transfer—in treating cases of premature luteinizationPatients experiencing premature luteinization during controlled ovarian stimulation—identified by extremely high progesterone levels at induction P levels ≥30 ng/ml and/or P/estradiol ratio ≥1 n = 42—were included in a “freezeall” program and compared to controls undergoing a “freezeall” program with normal progesterone levels at induction P 15 ng/ml n = 67Blastulation rate was comparable between patients with premature luteinization and controls 481 ± 205 in Cases vs 523 ± 249 in Controls p = 036 Ongoing pregnancy rates after the first frozenthawed embryo transfer 381 in Cases and 410 in Controls p = 083 and cumulative ongoing pregnancy rates after three frozenthawed embryo transfer cycles 405 in Cases vs 478 in Controls p = 055 were also similarThese results show that extremely marked progesterone elevation throughout controlled ovarian stimulation does not impair blastocyst development and implantation potential in the context of a “freezeall” strategy Based on this adoption of the “freezeall” strategy represents a valuable tool in treating premature luteinization In contrast cycle cancellation—likely the most frequently used method for management of this complication—currently represents a misconduct
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