key: cord-0733344-4lbvau9i authors: Melo, Anderson S.; Paula, Camilla T.V.; Santos, Thiago L.; Faria, Victor A.C.; Rufato, Marcelo A.F.; Barboza, Rebecca P.; Barreto, Jorge title: FRIENDLY PROTOCOL FOR OOCYTE DONORS: FERTILITY OPTIMIZATION IN TIMES OF SOCIAL ISOLATION DUE TO COVID-19? date: 2020-09-30 journal: Fertility and Sterility DOI: 10.1016/j.fertnstert.2020.08.1327 sha: af9a87389d3b99b224370287b7ee498292003957 doc_id: 733344 cord_uid: 4lbvau9i nan CONCLUSIONS: Friendly protocol for IVF seems to be safe (same risk of OHSS) and effective (oocyte mature and clinical pregnancy rate) in comparison to the conventional protocol in oocyte donors. The smaller number of visits to the clinic with the friendly protocol can be a great ally in times of social isolation due to the pandemic by COVID-19. Clomiphene citrate and letrozole to reduce follicle-stimulating hormone consumption during ovarian stimulation: systematic review and meta-analysis Valeurs compar ees de la corifollitropine alpha et de la FSH quotidienne dans la stimulation ovarienne des donneuses d'ovocytes A comparison of live birth rates and cumulative ongoing pregnancy rates between Europe and North America after ovarian stimulation with corifollitropin alfa or recombinant folliclestimulating hormone Innovations in assisted reproductive technologies: impact on contemporary donor egg practice and future advances The impact of music therapy on pain and stress reduction during oocyte retrieval -a randomized controlled trial Corifollitropin alfa Ensure Study Group. Corifollitropin alfa for ovarian stimulation in IVF: a randomized trial in lower-body-weight women [published correction appears in Reprod Biomed Online ART in Europe, 2014: results generated from European registries by ESHRE: The European IVFmonitoring Consortium (EIM) for the European Society of Human Reproduction and Embryology (ESHRE) Epidemiology and prevention of ovarian hyperstimulation syndrome (OHSS): a review GnRH agonist trigger for the induction of oocyte maturation in GnRH antagonist IVF cycles: a SWOT analysis Oocyte donation: the legislative framework in Western Europe Neonatal outcomes and congenital malformations in children born after dydrogesterone application in progestin-primed ovarian stimulation protocol for IVF: a retrospective cohort study Ovarian hyperstimulation syndrome: review and new classification criteria for reporting in clinical trials Feasibility of corifollitropin alfa/ GnRH antagonist protocol combined with GnRH agonist triggering and freeze-all strategy in polycystic ovary syndrome patients Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation Recruiting egg donors online: an analysis of in vitro fertilization clinic and agency websites' adherence to American Society for Reproductive Medicine guidelines Recombinant gonadotrophin-based, ovarian hyperstimulation syndrome-free stimulation of the high responder: suggested protocol for further research Ovarian response markers lead to appropriate and effective use of corifollitropin alpha in assisted reproduction The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure New stimulation regimens: endogenous and exogenous progesterone use to block the LH surge during ovarian stimulation for IVF Practice Committee of the American Society for Reproductive Medicine. Electronic address: ASRM@asrm.org; Practice Committee of the American Society for Reproductive Medicine. 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Mcgovern, MD, 3 Sara S. Morelli, MD, PhD 1 1 Rutgers New Jersey Medical School, Newark, NJ; 2 Rutgers New Jersey Medical School, Newark, New Jersey, NJ; 3 University Reproductive Associates, NJ, Hasbrouck Heights, NJ. OBJECTIVE: During the use of assisted reproductive technologies for conception or oocyte cryopreservation, each patient is monitored with serial ultrasounds and serum hormone concentrations: particularly estradiol, progesterone, and the gonadotropins follicle stimulating hormone (FSH) and luteinizing hormone (LH). Several studies have evaluated these levels at the time of trigger for oocyte maturation in comparison with live birth rates. However, very few studies have evaluated the change in endocrine levels on the day after trigger in correlation with oocyte maturation and pregnancy outcomes. Thus, the objective of this study was to determine if the change in endocrine hormone levels on the day after trigger with human chorionic gonadotropin with or without a gonadotropin-releasing hormone agonist affects the number of good quality oocytes during controlled oocyte stimulation cycles.DESIGN: Retrospective cohort study at an academic-affiliated private practice.MATERIALS AND METHODS: All patients undergoing controlled oocyte stimulation cycles with the use of gonadotropins for in-vitro fertilization (IVF) or oocyte cryopreservation from September 2018 through December 2019 were assessed for inclusion. The charts of patients with successful oocyte retrieval were systematically examined and all necessary data collected, including serum concentrations of estradiol, progesterone, FSH, and LH throughout each cycle. The primary outcome was the number of mature oocytes (identified as oocytes in metaphase II at the time of oocyte retrieval) in each stimulation cycle. Statistical analysis was performed using student t-test, one-way ANOVA, and Spearman's correlation where applicable. Data are expressed as mean AE standard deviation. This study was IRB approved.RESULTS: Of the 372 patients who underwent controlled ovarian stimulation with gonadotropins during the study period, the 360 that were included for analysis had a mean maternal age of 37.3 AE 4.2 years and BMI of 27.6 AE 7.8. Most patients underwent antagonist cycles (n¼295) compared with those who underwent agonist stimulation cycles (n¼65). In all cycles, the percent change in progesterone levels from the day of trigger to the levels one day after trigger was statistically significant with an increasing number of mature oocytes (R¼0.522; p<0.0001). Interestingly, the change in FSH levels before and after trigger were significantly different between antagonist and agonist cycles (p<0.001). Antagonist cycles resulted in increased FSH levels posttrigger (17.05% AE 67.3%), while there was an overall decrease in FSH levels post-trigger in agonist cycles (-11 .37% AE 20.83%).CONCLUSIONS: The change in serum hormone endocrine levels, particularly progesterone, before and after trigger for oocyte maturation can affect the number of mature oocytes yielded. The greater the change of progesterone levels post-trigger results in a higher number of mature oocytes. The percent change in progesterone levels can be used as a predictor of higherquality oocyte yield in controlled ovarian stimulation cycles. DESIGN: Retrospective cohort study. MATERIALS AND METHODS: A retrospective chart review identified patients who completed more than one controlled ovarian stimulation cycle, within a 12-month period, at the University of California, Center for Reproductive Health, between January 2018 and December 2019. Descriptive statistics were performed. A mixed generalized linear model (GLM) was used to determine variables associated with variability in oocyte yield. Subgroup analyses were performed to investigate the variability in oocyte yield by treatment protocol.RESULTS: There were 520 patients included in the analytic sample. Most patients were 40 years old or younger (71.9%) with a primary diagnosis of diminished ovarian reserve (33.6%). The protocols utilized among patients