1. Does pituitary suppression affect live birth rate in women with congenital hypogonadotrophic hypogonadism undergoing intra-cytoplasmic sperm injection? A multicenter cohort study.
- Author
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Mumusoglu, Sezcan, Ata, Baris, Turan, Volkan, Demir, Berfu, Kahyaoglu, Inci, Aslan, Kiper, Seyhan Ata, Ayse, Yilmaz, Bulent, Yakin, Kayhan, Avci, Berrin, Uncu, Gurkan, and Bozdag, Gurkan
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CHILDBIRTH , *HYPOGONADISM , *COHORT analysis , *LOGISTIC regression analysis , *LUTEINIZING hormone releasing hormone - Abstract
In this retrospective multicenter cohort study, women with congenital hypogonadotrophic hypogonadism (CHH) (n = 57) who underwent intra-cytoplasmic sperm injection in-between 2010–2014 were compared to age-matched controls with tubal factor infertility (n = 114) to assess ovarian stimulation cycle and pregnancy outcomes. Live birth rates (LBRs) per started cycle were 31.6 and 24.6% in CHH and controls groups, respectively (p = 0.36). Comparable success rates were also confirmed with the logistic regression analysis (OR: 1.44, 95% CI: 0.78–2.67,p = 0.24). Of the 57 women with CHH, 19 were stimulated with the gonadotropin-releasing hormone (GnRH) antagonist protocol, 13 with the long-GnRH-agonist protocol. Pituitary suppression (PS) was not employed in the remaining 25 cases. Compared to women with PS, women without PS had significantly higher embryo implantation rates (21.6 versus 52.6%,p = 0.03). Although there was a trend favoring no PS, LBRs (25.0 versus 40.0%,p = 0.26) per cycle were short of statistical significance. LBRs per cycle (57.1 versus 31.2%,p = 0.11) and miscarriage rates (11.1 versus 16.7%,p = 0.75) were similar between CHH women who were given estrogen + progesterone and progesterone alone to support the luteal phase. In conclusion, the optimal stimulation protocol appears to be exogenous gonadotropin stimulation alone, without PS, and progesterone-only luteal phase support in CHH patients. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
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