Work

The effectiveness of in vitro fertilization programs depending on the type of ovarian response to stimulation

Year: 2025

Type: article

Abstract: The paper identiﬁes the main groups of patients in vitro fertilization (IVF) programs. The characterization of the unexpected (paradoxical) response and its association with the polymorphism of the FSHR gene is given. A comparative characteristic of СOS protocols with the original follitropin alpha and its domestic biosimilar is presented. The aim of the study is to increase the eﬀectiveness of IVF programs in patients with an unexpected response by developing a diﬀerentiated approach to ovarian stimulation. Material and methods. At the 1st stage, 920 case histories were studied; at the 2nd, 197 patients were included — a characteristic of patients with an unexpected response and its association with FSHR gene polymorphism was given; at the 3rd, an algorithm for a diﬀerentiated approach to СOS was tested in 22 patients. Results. The main groups diﬀer in age, eﬃcacy, and the amount of gonadotropins. The frequency of the unexpected response was 42.8%. When comparing the original follitropin alpha and its domestic biosimilar, the eﬀectiveness was 36.46 and 40.59% (p = 0.0511), respectively. Genotype G/A of the FSHR gene polymorphism is associated with a normal response; genotype A/A with a poor response; genotype G/G with a high response (p < 0.0001). The frequency of repeated unexpected response was 21.3%, the eﬃciency per cycle was 39.1% according to the results of testing the algorithm. Conclusion. Three main groups of IVF patients have been identiﬁed to calculate the required doses of gonadotropins. An unexpected ovarian response reduces the eﬀectiveness of IVF programs by 8.5%. Polymorphism of the FSHR gene is a signiﬁcant predictor of a repeated unexpected response. The developed algorithm of the diﬀerentiated approach to the СOS makes it possible to increase the eﬀectiveness of IVF programs.

Source: Clinical Medicine (Russian Journal)

DOI: 10.30629/0023-2149-2024-102-11-12-901-907

Authors: S. Ya. Ostrina, O. F. Serova, E. B. Rudakova, E. A. Fedorova

Institutions: State Scientific Center of the Russian Federation - Federal Medical Biophysical Center named after A.I. Burnazyan, Federal Medical-Biological Agency

Language: English

Topic: Reproductive Health and Technologies

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4408381407

FWCI:

Cites: 13

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Related to: 10