[Impact of high response of ovary to gonadotropin stimulation on the outcome of in vitro fertilization and embryo transfer or intracytoplasmic sperm injection].

OBJECTIVE

To evaluate the impact of elevated peak estradiol (E(2)) levels and a high number of retrieved oocytes on implantation and pregnancy rate in patients undergoing in vitro fertilization-embryo transfer (IVF-ET) and intracytoplasmic sperm injection (ICSI).

METHODS

Retrospectively analyzed 474 infertile women undergoing 510 cycles for IVF-ET/ICSI treatment during the period of March 1999 to December 2000. Using a standard long protocol/flare-up protocol [(gonadotropic hormone releasing hormone agonist/high pure follicle-stimulating hormone (FSH-HP)/human chorionic gonadotropin (hCG)] for ovarian stimulation. High responders were defined as those who had peak E(2) levels of > 11 010 pmol/L on the day of hCG administration (n = 160) or > 15 retrieved oocytes (n = 148). Normal responders were defined as those who had peak E(2) levels of </= 11 010 pmol/L on the day of hCG administration (n = 350) or </= 15 retrieved oocytes (n = 362).

RESULTS

There were statistically significant differences in age, infertile years, basal FSH level and the ampules of FSH-HP required between high and normal responders (P < 0.01 and P < 0.05). Ovarian hyperstimulation syndrome (OHSS) increased significantly in the high responders (P < 0.01). There were no statistically significant differences in implantation rate or pregnancy rate between high and normal responders.

CONCLUSION

Elevated peak E(2) levels and high oocytes retrieved were not detrimental to IVF outcome, but had high incidence of OHSS.