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Infertility treatment strategy involving combined freeze‐all embryos and single vitrified‐warmed embryo transfer during hormonal replacement cycle for in vitro fertilization of women with hypogonadotropic hypogonadism
Author(s) -
Kuroda Keiji,
Ezoe Kenji,
Kato Keiichi,
Yabuuchi Akiko,
Segawa Tomoya,
Kobayashi Tamotsu,
Ochiai Asako,
Katoh Noriko,
Takeda Satoru
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13597
Subject(s) - medicine , in vitro fertilisation , embryo transfer , hypogonadotropic hypogonadism , controlled ovarian hyperstimulation , live birth , pregnancy , infertility , gynecology , luteinizing hormone , pregnancy rate , assisted reproductive technology , single embryo transfer , andrology , obstetrics , hormone , endocrinology , biology , genetics
Aim Hypogonadotropic hypogonadism (HH) is a condition caused by the deficient secretion of pituitary gonadotropins, leading to diminished ovarian function. Several studies of in vitro fertilization (IVF) in women with HH revealed acceptable clinical pregnancy outcomes but high multiple pregnancy rates after multiple fresh embryo transfer (ET). The purpose of this study was to analyze the outcomes of combined freeze‐all embryos and single vitrified‐warmed ET in women with HH. Methods Of 91 infertile women with HH (basal luteinizing hormone and follicle‐stimulating hormone levels <2.0 mIU/mL), we excluded patients aged ≥40 years ( n = 2) and women who preferred fresh ET ( n = 10). Seventy‐nine women underwent 117 oocyte retrieval cycles and 135 vitrified‐warmed ET during hormone replacement (HR) cycles from 2008 to 2014 at the Kato Ladies Clinic and Juntendo University Hospital. Results In 26 single cleavage ET cycles, the rates of clinical pregnancy and live birth were 34.6% (9/26 ET) and 26.9% (7/26 ET), respectively. Regarding the outcomes after single vitrified‐warmed blastocyst transfer, clinical pregnancy and live birth rates were 65.1% (71/109 ET) and 50.5% (55/109 ET), respectively. Multiple conceptions and ovarian hyperstimulation syndrome did not occur in any of the women with HH. Conclusion Our results demonstrated that IVF followed by single vitrified‐warmed ET in adjusted endocrine milieu during the HR cycle is an effective fertility treatment for women with HH and decreases the incidence of complications, including multiple conceptions.