Clomiphene based ovarian stimulation in a commercial donor program

Shruti Gupta, Ruma Satwik, Abha Majumdar, Shweta Mittal, Neeti Tiwari
2015 Journal of Human Reproductive Sciences  
for prolonged durations, leading to increased costs and adverse effect on oocyte quality. [1] Antagonist protocol, when used with GnRH agonist trigger, does reduce the risk of moderate to severe OHSS. The use of clomiphene seems another attractive alternative for donors as it may reduce the dose of stimulation and at the same time eliminate the need for the antagonist. Clomiphene based ovarian stimulation in a commercial donor program ABSTRACT OBJECTIVE: This study was conducted to compare an
more » ... tended clomiphene-based ovarian stimulation regimen with the conventional antagonist protocol in donor-recipient cycles. MATERIALS AND METHODS: A total of 170 (N) donors were stimulated between January 2013 and December 2013. Conventional antagonist protocol (group I) was employed in (n1 = 31) cycles, and clomiphene was used in (n2 = 139) donor cycles (group II). 50 mg clomiphene was given simultaneously with gonadotropins from day 2 of the cycle until the day of trigger. The analysis was performed retrospectively for oocytes retrieved, fertilization rates, cycle cancelation, blastocyst formation, and pregnancy rates. The dosages, cost, and terminal E2 (estradiol) were also compared between the two groups. RESULTS: The donor age groups were comparable in both the groups. There were no unsuccessful egg retrievals with clomiphene. The pregnancy rate (positive beta human chorionic gonadotropin) was significantly higher in the clomiphene group (odds ratio: 2.453; P = 0.02). Similarly, fertilization rate was significantly higher in the clomiphene group (59.5/50.5, P = 0.04). Eggs retrieved were similar in both groups, but the terminal E2 was significantly higher in the clomiphene group (P = 0.001). Average gonadotropin used was also significantly lower in clomiphene group (P < 0.001). CONCLUSION: Clomiphene can effectively prevent luteinizing hormone surge and limit the dose of gonadotropins thus bringing down the costs and its negative impact on the endometrium and oocyte quality.
doi:10.4103/0974-1208.165151 pmid:26538856 pmcid:PMC4601172 fatcat:gwwumswcvnggrdqzypx6x25fgy