OVARIAN ACTIVITY DURING FOLLICULAR-PHASE DOWN-REGULATION IN IN-VITRO FERTILIZATION IS ASSOCIATED WITH ADVANCED MATERNAL AGE AND A HIGH RECURRENCE RATE IN SUBSEQUENT CYCLES

Purpose: Previous reports have suggested that the ovarian response to leuprolide acetate is predictive of in vitro fertilization pregnancy r ates. This study evaluated the outcome of in vitro fertilization cycle s complicated by elevated estradiol levels during leuprolide acetate d own regulation and the outcome of subsequent cycles in the same patien ts. Methods: Two hundred fifty-two in vitro fertilization cycles were initiated utilizing leuprolide acetate down regulation beginning on cy cle day 1. Results: Seventy-four of these cycles had an elevated estra diol level at the time of the baseline scan (28%). This group of patie nts had a higher maternal age, a higher cycle cancellation rate (27.5 vs 16.3%), and a high rate of recurrence on subsequent cycles (63%). C onclusions: The pregnancy rate per retrieval was equivalent in the two groups. This suggests that patients with advanced maternal age or a h istory of failure to suppress in a previous cycle may benefit from alt ernate regimens of superovulation.