By Bin Wu, embriolog
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Extra info for Advances in embryo transfer
Our IVF center has reduced the price by 50% when the mild stimulation method is used. Also, using less FSH markedly reduces the risk of OHSS. Interestingly, one of the arguments in favor of conventional stimulation is that the more embryos developed the better chance of chromosomally normal embryos. Proponents of mild stimulation consider that oocytes with meiotic errors identified in the natural ovulatory process are more likely to undergo apoptosis and can not advance to a dominant follicle stage.
Sometimes a GnRH agonist is used in 1 or 2 injections to stimulate endogenous gonadotropin release instead of hCG to reduce the risk of OHSS (11). 3 High dose FSH protocols The high dosage FSH protocols are those that start with greater than 300 U of FSH. They are frequently used by IVF-ET centers to try to increase the follicular response in previous poor responders. 4. 1 Conventional FSH stimulation over mild stimulation Conventional COH produces more oocytes and thus more embryos. Theoretically this procedure will obtain more top quality embryos for transfer, especially considering a blastocyst transfer.
Meta-analysis of prospective studies can increase the power but frequently there are journal reviewer and author biases in the publication of multiple studies. Clinically important conclusions can be reached from large retrospective studies comparing two therapeutic options if there are no apparent biases or inadvertent confounding variables. It is impossible to compare conventional vs. mild FSH stimulation with a large prospective RCT since there is little motivation for a pharmaceutical company to fund such a study.
Advances in embryo transfer by Bin Wu, embriolog