Initiating Dose of hMG in Clomiphene plus hMG regimen in aged patients with poor ovarian response: More is better?

Abstract

Abstract Object: This study was to investigate the effect of different human Menotrophin (hMG) initiation doses on in vitro fertilization (IVF) outcomes in aged poor ovarian response(POR) patients undergoing ovulation induction with Clomiphene Citrate (CC) combined with hMG; Method: The clinical data of 142 POR patients more than 40 years old were collected and were divided into 3 groups according to the initiation dose of hMG (Group A=75IU, Group B=150IU, Group C=225IU). The baseline characteristics and IVF outcomes were compared; Results: We found that with the increase of hMG initiation dose, the average number of oocytes retrieved increased, pair-to-pair comparison showed that the the average number of oocytes retrieved in Group Awas significantly lower than that in the Group B and Group C(P<0.05). Compared with Group B, the fertilization rate and oocyte utilization rate of patients in Group C were significantly lower (P<0.05). There was no significant difference in MII oocyte rate, Cleavage rate, embryo formation rate, high-quality embryo rate and pregnancy outcomes among the three groups(P>0.05). Conclusions: For aged POR patients receiving CC combined with hMG, increasing hMG cannot improve patients' IVF outcomes and Pregnancy outcomes. 150IU of hMG initiation dose may be the better choice for aged POR patients.