TY - JOUR
T1 - Use of clomiphene citrate in minimal stimulation in vitro fertilization negatively impacts endometrial thickness
T2 - An argument for a freeze-all approach
AU - Reed, Beverly G.
AU - Wu, John L.
AU - Nemer, Laurice Bou
AU - Carr, Bruce R
AU - Bukulmez, Orhan
N1 - Publisher Copyright:
© 2018, Sociedade Brasileira de Reproducao Assistida. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Objective: Minimal stimulation IVF is a treatment option that uses clomiphene citrate (CC). We sought to evaluate how CC impacts endometrial thickness during minimal stimulation IVF cycles. Methods: We retrospectively analyzed a cohort of 230 cycles in 119 poor ovarian response patients. The IVF cycles were studied in three groups: 130 minimal stimulation cycles, 29 mild stimulation cycles, and 30 conventional high dose gonadotropin releasing hormone (GnRH) antagonist cycles. Thirty-three minimal stimulation IVF patients had 41 frozen embryo transfers (FET) which allowed us to study whether the CC effects were prolonged. Results: Endometrial thickness in the minimal stimulation group was significantly lower than the mild and conventional stimulation groups (7.3±2.2mm versus 11.4±3.3mm versus 12.9±3.8mm, respectively, p<0.0001). In patients who underwent minimal stimulation IVF followed by FET, significantly thicker endometrial thickness was achieved during their FET cycles as compared to their minimal stimulation cycles (7.95±2.1mm versus 10.3±1.8mm, p<0.0001). Conclusion: We concluded that endometrial thickness is impacted during minimal stimulation IVF cycles. Since negative effects on endometrial thickness are not observed in the patients’ subsequent FET cycle, a freeze-all approach is justified to mitigate adverse endometrial effects of CC in minimal stimulation IVF cycles.
AB - Objective: Minimal stimulation IVF is a treatment option that uses clomiphene citrate (CC). We sought to evaluate how CC impacts endometrial thickness during minimal stimulation IVF cycles. Methods: We retrospectively analyzed a cohort of 230 cycles in 119 poor ovarian response patients. The IVF cycles were studied in three groups: 130 minimal stimulation cycles, 29 mild stimulation cycles, and 30 conventional high dose gonadotropin releasing hormone (GnRH) antagonist cycles. Thirty-three minimal stimulation IVF patients had 41 frozen embryo transfers (FET) which allowed us to study whether the CC effects were prolonged. Results: Endometrial thickness in the minimal stimulation group was significantly lower than the mild and conventional stimulation groups (7.3±2.2mm versus 11.4±3.3mm versus 12.9±3.8mm, respectively, p<0.0001). In patients who underwent minimal stimulation IVF followed by FET, significantly thicker endometrial thickness was achieved during their FET cycles as compared to their minimal stimulation cycles (7.95±2.1mm versus 10.3±1.8mm, p<0.0001). Conclusion: We concluded that endometrial thickness is impacted during minimal stimulation IVF cycles. Since negative effects on endometrial thickness are not observed in the patients’ subsequent FET cycle, a freeze-all approach is justified to mitigate adverse endometrial effects of CC in minimal stimulation IVF cycles.
KW - Advanced reproductive age
KW - Clomiphene citrate
KW - Diminished ovarian reserve
KW - Endometrial stripe thickness
KW - In vitro fertilization
KW - Minimal stimulation
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U2 - 10.5935/1518-0557.20180070
DO - 10.5935/1518-0557.20180070
M3 - Article
C2 - 30264948
AN - SCOPUS:85055661219
SN - 1517-5693
VL - 22
SP - 355
EP - 362
JO - Jornal Brasileiro de Reproducao Assistida
JF - Jornal Brasileiro de Reproducao Assistida
IS - 4
ER -