Ovarian Response Prediction in In Vitro Fertilization (IVF) Patients
Condition: Infertility, Subfertility
MeSH terms: Infertility
Study type: Observational

Summary: 
      The aim of the study is to explore ovarian response in terms of oocyte numbers after ovarian
      stimulation in a fixed gonadotropin dose GnRH-antagonist protocol by endocrine (AMH, FSH),
      demographic (age), sonographic (antral follicle count) and genetic factors (polymorphisms of
      gonadotropin receptors and secreted gonadotropins).
    

Detailed description: 
      Assisted reproduction by in-vitro fertilisation plays a pivotal role in the treatment of
      infertility, the understanding of reproductive biology, and future population dynamics. The
      success of assisted reproductive technologies (ART) is critically dependent on optimizing
      protocols for controlled ovarian stimulation which aim at providing an adequate number of
      good quality oocytes for in-vitro laboratory procedures. Interindividual variation in
      response to follicle-stimulating hormone (FSH) is a widespread problem with clinical and
      economical implications. A group of patients (9%-24%) tend to respond poorly to controlled
      ovarian stimulation (COS) whereas other patients tend to overrespond (2.5%) and thus run at
      risk of developing ovarian hyperstimulation syndrome, a potentially life-threatening disease.
      Polymorphisms of gonadotropin receptors seem to have an influence on the outcome of
      controlled ovarian hyperstimulation treatment, e.g. contributing to the variation in ovarian
      response to exogenous FSH between individuals. Other predictive factors include demographic
      (age), sonographic (follicular count in the ovaries, ovarian volume), endocrine (serum
      gonadotropin levels and Anti-Muellerian Hormone) and life-style factors (smoking, obesity).
      Such factors are routinely obtained prior to a treatment cycle, and are used to determine the
      optimal FSH starting dose or the best treatment regimen. The identification of gonadotropin
      receptor polymorphisms and variants in secreted gonadotropins prior to an ovarian stimulation
      treatment should allow the clinicians to tailor the starting dose of rFSH, especially for
      patients undergoing their first treatment cycle, as such ovarian response prediction will
      prevent cycle cancellations due to too low or too high ovarian response and reduce the risk
      of OHSS. The aim of the present study is to identify the prevalence of FSH and LH receptor
      polymorphisms and hormonal variants of LH and to study the variation attributable to these
      genetics factors when controlling for already established predictors of ovarian response to
      exogenous FSH in a multi-variate analysis.
    

Intervention name(s): Ovarian stimulation in a GnRH-antagonist protocol
Intervention type(s): Drug
Intervention description(s): Long-acting FSH 150µg & daily recombinant FSH 200 IU, GnRH-antagonist 0.25mg, 5,000-10,000 IU urinary hCG, triptorelin 0.2mg, vaginal progesterone
Other intervention name(s): Elonva, Puregon, Orgalutran, Predalon, Crinone
Intervention MeSH terms: Ganirelix
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Female patients with an indication for IVF or ICSI
      
Biospecimen description: 
      Serum samples for analysis of gonadotropins and Anti-Muellerian Hormone EDTA samples for DNA
      extraction
    
Keywords: ovarian stimulation; recombinant FSH; GnRH-antagonist; corifollitropin alfa