Abstract
Objective: To evaluate, in women scheduled for IVF with predicted poor ovarian response, the effect of increased dosing of gonadotropin on maternal and neonatal outcomes compared with standard dosing. Study design: We performed a follow-up study of an open-labelled randomized controlled trial comparing increased (225 or 300 IU/d) versus standard (150 IU/d) dose gonadotrophins on cumulative live birth rates. We randomized 661 women with a predicted poor ovarian response (based on their antral follicle count) scheduled for their first IVF/ICSI cycle. Here, we report on maternal and neonatal outcomes between increased and standard dosing groups. Results: There was a trend of increased risk of gestational diabetes mellitus in the increased gonadotrophin dose group compared with the standard group in both cumulative live birth pregnancies (14.8% vs. 7.8%, relative risk (RR) 1.90, 95% confidence interval (CI) 0.96–3.74, P = 0.06) and live birth pregnancies in the first transfer (15.2% vs. 7.7%, RR 1.98, 95 %CI 0.93–4.19, P = 0.08), without reaching statistical significance. The occurrence of gestational diabetes mellitus was significantly higher in the increased gonadotrophin dose group (24/149, 16.1% vs. 8/128, 6.3%; risk ratio (RR) 2.58, 95 %CI 1.19 to 5.54, P = 0.02) in singleton pregnancies. In women with first embryo transfer cycle, maternal hypothyroidism occurred also more frequent in the increased gonadotrophin dose group than the standard group (16.0% vs. 6.8%, RR 2.34, 95 %CI:1.07–5.11, P = 0.03). Conclusions: In women with predicted poor ovarian response, increased dosing of gonadotropin may result in an increased risk of gestational diabetes mellitus and maternal hypothyroidism.
Original language | English |
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Pages (from-to) | 123-129 |
Number of pages | 7 |
Journal | European Journal of Obstetrics and Gynecology and Reproductive Biology |
Volume | 285 |
Early online date | 25 Apr 2023 |
DOIs | |
Publication status | Published - Jun 2023 |
Bibliographical note
Funding Information:We thank the staff from Northwest Women's and Children's Hospital for their assistance with the data collection. We thank all participants in this study.
Funding Information:
Supported by the General Projects of Social Development in Shaanxi Province (No. 2022SF-565).
Keywords
- Gestational diabetes mellitus
- Hypothyroidism
- Increased dosing
- Poor ovarian response
- Standard dosing