#325 : A Comparison of Three Different IVF FSH Dosing Strategies for PCOS Patients; A Retrospective Analysis of 855 IVF Cycles

Abstract

Background and Aims: IVF responses to gonadotrophins may be difficult to predict in patients with PCOS. Nowadays there are various options including using the strategy of GnRH agonist trigger and freeze all embryos. The follitropin delta dosing algorithm has been used to predict an ovarian response that reduces the effects of ovarian hyperstimulation syndrome. The aim of this study was to compare the outcomes of three different FSH dosing strategies in PCOS patients. Methods: This retrospective multi-centre trial enrolled 626 PCOS women. They underwent 855 stimulated IVF cycles using a GnRH antagonist protocol and 634 frozen embryo transfers with embryos from the original stimulated cycles. Patients were classified into 3 groups: Group 1 (underdosing), Group 2 (algorithm dosing) and group 3 (overdosing). The algorithmic dose was based on the follitropin delta algorithm using AMH and body weight. The main outcome measure was the live birth rate per cycle started. Results: The live birth rate per cycle was 40.8% for group 1, 42.1% for group 2 and 45.5% for group 3. Group 3 had the greatest average number of embryos frozen (1.55 embryos in group 1, 2.45 group 2 and 2.96 group 3). The average number of eggs collected was greatest in group 3 (8.7 eggs in group 1, 11.9 group 2 and 14.2 group 3). The most frozen of all cycles occurred in group 3 (45.6%). Conclusions: Higher FSH dosing resulted in more eggs and more live births per cycle started. It also resulted in less fresh embryo transfers. These results could be used when choosing an FSH dosing strategy for PCOS patients.