Table 2.
Comparison of baseline, end-of-stimulation, oocyte and embryo characteristics between HP-hMG- and rFSH-treated women with potential for being high-responders by a high AMH at start of stimulation.
| Variable | Long GnRH agonist protocol |
GnRH antagonist protocol |
||||
|---|---|---|---|---|---|---|
| AMH Q4: >75th (>5.2 ng/ml) |
AMH Q4: >75th (>5.2 ng/ml) |
|||||
| HP-hMG (n = 76) | rFSH (n = 79) | p Value* | HP-hMG (n = 87) | rFSH (n = 101) | p Value* | |
| Clinical characteristics | ||||||
| Age (years) | 30 (28, 32) | 30 (28, 32) | 0.743 | 30 (28, 33) | 30 (28, 31) | 0.039 |
| BMI (kg/m2) | 22.5 (20.7, 23.8) | 20.8 (19.8, 22.8) | 0.002 | 22.1 (21.0, 23.9) | 21.6 (20.1, 23.0) | 0.022 |
| Cycle length (days) | 29 (28, 30) | 29 (28, 30) | 0.682 | 29 (28, 30) | 29 (28, 31) | 0.382 |
| First treatment cycle, n (%) | 52 (68%) | 52 (66%) | 0.731 | 57(66%) | 77 (76%) | 0.105 |
| Day 1 (before start of stimulation) | ||||||
| Ovarian volume (ml) | 10.3 (7.9, 13.9) | 10.5 (7.7, 14.8) | 0.807 | 13.4 (9.1, 17.0) | 13.0 (9.9, 16.7) | 0.885 |
| AFC (n) | 12 (8, 20) | 11 (8, 16) | 0.486 | 18 (15, 22) | 18 (15, 22) | 0.934 |
| AMH (ng/ml) | 7.0 (5.9, 8.5) | 7.0 (5.7, 8.4) | 0.912 | 7.1 (6.2, 8.7) | 6.8 (6.0, 8.3) | 0.347 |
| FSH (IU/l) | 3.2 (2.6, 4.4) | 3.6 (2.8, 4.4) | 0.257 | 6.7 (5.6, 7.7) | 6.4 (5.7, 7.5) | 0.251 |
| End-of-stimulation | ||||||
| Estradiol (nmol/l) | 8.7 (6.4, 13.0) | 8.4 (6.1, 12.8) | 0.736 | 9.7 (6.8, 14.8) | 7.8 (5.5, 12.4) | 0.012 |
| Progesterone (nmol/l) | 2.7 (1.9, 3.6) | 3.6 (2.8, 4.5) | <0.001 | 2.8 (2.1, 3.9) | 3.0 (2.1, 3.8) | 0.857 |
| Progesterone/estradiol ratio | 0.31 (0.21, 0.42) | 0.43 (0.30, 0.52) | <0.001 | 0.26 (0.20, 0.41) | 0.34 (0.24, 0.47) | 0.011 |
| Follicles ≥12 mm (n) | 15 (12, 18) | 16 (13, 19) | 0.274 | 14 (11, 18) | 16 (12, 19) | 0.064 |
| Endometrial thickness (mm) | 11 (10, 12) | 11 (10, 12) | 0.522 | 11 (10, 12) | 11 (10, 12) | 0.478 |
| Endometrial echogenicity pattern (hypo, iso, hyper) (%) | 44, 43, 13 | 24, 60, 17 | 0.033 | 31, 58, 11 | 41, 50, 9 | 0.386 |
| Cycle cancellation for ovarian hyper-response, n (%) | 3 (4%) | 4 (5%) | 1.000 | 0 (0%) | 1 (<1%) | – |
| Early OHSS (moderate/severe), n (%) | 3 (4%) | 4 (5%) | 1.000 | 3 (3%) | 5 (5%) | 0.727 |
| Intervention for ovarian hyper-response, n (%) | 5 (7%) | 6 (8%) | 1.000 | 7 (8%) | 12 (12%) | 0.470 |
| Oocyte retrieval | ||||||
| Women with oocyte retrieval, n (%) | 72 (95%) | 73 (92%) | 0.555 | 85 (98%) | 100 (99%) | 0.475 |
| Oocytes retrieved (n) | 12 (9, 16) | 15 (11, 20) | 0.007 | 12 (8, 15) | 14 (10, 19) | 0.033 |
| Women with ≥15 oocytes retrieved, n (%) | 25 (33%) | 40 (51%) | 0.025 | 27 (31%) | 49 (49%) | 0.015 |
| Fertilisation and embryo data | ||||||
| Fertilisation rate (%) | 50 (27, 73) | 56 (35, 69) | 0.826 | 57 (43, 69) | 60 (41, 73) | 0.663 |
| Embryos on day 3 (n) | 3 (2, 6) | 4 (2, 6) | 0.806 | |||
| Women with top-quality embryo(s) on day 3, n (%)† | 38 (53%) | 35 (48%) | 0.561 | |||
| Blastocysts on day 5 (n) | 3 (1, 6) | 3 (1, 6) | 0.969 | |||
| Women with good-quality blastocyst(s) on day 5, n (%)‡ | 55 (65%) | 51 (51%) | 0.060 | |||
| Women with transfer, n (%)¶ | 61 (85%) | 61 (84%) | 0.848 | 72 (85%) | 87 (87%) | 0.655 |
Values are median (IQR) unless otherwise indicated.
*
Wilcoxon test (continous data); Chi-Square test or Fisher’s exact test (categorial data).
†
Top-quality embryos were defined as 4–5 cells on day 2, ≥7 cells on day 3, equally-sized blastomeres and ≤20% fragmentation on day 3 and no multinucleation.
‡
Good-quality blastocysts were defined as blastocysts with expansion and hatching score ≥4 and with inner cell mass and trophectoderm grades of A or B, using the definitions described by Gardner & Schoolcraft [23].
¶
Among women with oocytes retrieved.