Impact of pituitary suppression on antral follicle count and oocyte recovery after ovarian stimulation

Capsule:
We discuss how short-term pituitary suppression decreases antral follicle count.

Authors:
Nam D. Tran, M.D., Ph.D., Lusine Aghajanova, M.D., Ph.D., Chia-Ning Kao, M.S., Marcelle I. Cedars, M.D., Mitchell P. Rosen, M.D.

Volume 105, Issue 3, Pages 690-696

Abstract:

Objective:
To investigate the potential influence of short-term pituitary suppression on antral follicle count (AFC) and correlate the AFC with the number of oocytes retrieved after ovarian stimulation.

Design:
Retrospective study.

Setting:
University fertility center.

Patient(s):
A total of 1,479 infertile patients.

Intervention(s):
Patients had baseline AFC, when they were not on any medications known to cause pituitary suppression, and follow-up AFC (suppressed AFC) while on E2, GnRH agonist (GnRH-a), oral contraceptive (OC) pills, or OC pills/GnRH-a in preparation for ovarian stimulation, performed within 6 months of initial baseline AFC.

Main Outcome Measure(s):
The AFC at baseline, AFC during pituitary suppression, and the number of oocytes retrieved.

Result(s):
Although there was an average unadjusted decline of 0.4, 0.9, 2.2, and 3.0 in AFC while patients were on E2, GnRH-a, OC pills, and OC pills/GnRH-a, respectively, this decline was driven by age, baseline AFC, and the hormones used. Although baseline and suppressed AFC were found to be good predictors of the number of oocytes retrieved after ovarian stimulation, statistically, suppressed AFC was found to be a marginally better predictor.

Conclusion(s):
Short-term pituitary suppression has a negative impact on AFC. This decline in AFC may influence the number of oocytes retrieved, suggesting the suppressive impact of exogenous hormones on the biological capacity of the ovary during stimulation.

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