The impact of rescue in vitro fertilization converted from high-response gonadotropin intrauterine insemination cycles in terms of implantation and pregnancy rates as compared with matched controls

Objective

To determine whether conversion of high-response gonadotropin/intrauterine insemination (IUI) cycles to “rescue” in vitro fertilization (IVF) yields a higher implantation and pregnancy rate as found in matched IVF controls.

Design

A prospective study with a retrospective controlled section.

Setting

Baskent University Department of Obstetrics and Gynecology.

Patient(s)

Thirty-two patients switched from high response gonadotropin/IUI cycles to “rescue” IVF, 202 women with polycystic ovaries (PCO), and 452 women without PCO from the IVF database.

Intervention(s)

High-response gonadotropin/IUI cycles were converted to IVF to avoid cycle cancellation and high-order multiple pregnancies.

Main Outcome Measure(s)

Clinical parameters and characteristics of controlled ovarian hyperstimulation and intracytoplasmic sperm injection results.

Result(s)

The pregnancy rate was 78.1% in the rescue IVF group: 66.3% and 58.2% in the PCO and non-PCO groups, respectively. Clinical pregnancy rates and ongoing pregnancy rates also tended to be higher in the rescue IVF group but the difference was not statistically significant. The main difference between the groups was in the implantation rate: 37.5% in the rescue IVF group, which was greater than that of the PCO and non-PCO groups (27.58% and 24.46%, respectively).

Conclusion(s)

Our study demonstrates that conversion of gonadotropin IUI cycles in patients with excessive follicles to IVF is a safe, effective strategy. Implantation rates are higher than those in hyper-responder and normal responder IVF patients.

Key Words: Rescue IVF, implantation, GnRH antagonist, IUI