FRIENDLY PROTOCOL FOR OOCYTE DONORS: FERTILITY OPTIMIZATION IN TIMES OF SOCIAL ISOLATION DUE TO COVID-19?

Retrospective study

Please, see table below. Ovulatory factor, the number of visits to the clinic and the tubal factor were not predictors of obtaining mature oocytes (only antral follycle number was independent predictor). Variable Friendly protocol (n=52) Conventional protocol (n=66) Age(years) 30±3,8 29,1±4,9 Infertility time(years) 4,4±3,4 4,5 ± 3,2 Cause of infertility: Male(%) Ovulatory(%)** Tubal factor(%)** Other(%) 49,2 37,5 63,6 2,8 50,8 62,5 36,4 3,1 Induction days 10,4± 1,1 10,5±1,2 Number of visits to the clinic** 2,8±0,5 4,9±2,3 Follicles≥14 mm(hCG day) 14,7±5,5 12,7±6,2 Early ovulation 1,9 1,5 Number of mature eggs 18,5±10,1 17,2±9,2 Number of frozen embryos 7±4,7 5,3±2,2 Clinical pregnancy rate[n(%)] 20(40) 27(40,9) OHSS Mild(%) Moderate(%) Severe(%) 43,9 5,7 1,9 56,1 6,1 1,5 **p<0,05 **p<0,05

One hundred and eighteen infertile women aged 21 to 35 years old were divided into two groups: 1) Friendly: corifollitropin alfa (Elonva®), CC (Indux®) and dydrogesterone (Duphaston®); 2) Conventional: follitropin alfa (Gonal®), menotropin (Merional®) and ganirelix (Orgalutran®). All participated in the egg donation program and had ≥ 20 antral follicles before stimulation for IVF. The presence of hereditary or genetic diseases, infectious diseases, endometrial diseases, chronic diseases, adenomyosis, endometriosis were excluded. The variables analyzed were age, time and cause of infertility, number of days of induction and visits to the clinic (until trigger), number of follicles ≥14mm (trigger day), frequency of early ovulation (visualization of an image suggestive of follicular rupture before ovarian puncture), number of mature oocytes, frozen embryos, clinical pregnancy rate and OHSS (mild: pain (use of scopalamine + paracetamol) and/or nausea and/or vomiting; moderate: increased abdominal volume with evidence of clinical ascites without the need for hospitalization and moderate pain (use of codein); severe: hospitalization due to severe symptoms).

Compare the number of oocytes retrieved from oocyte donors subjected to vitro fertilization (IVF) in two different protocols: friendly (corifollitropin alfa + clomiphene citrate (CC) + dydrogesterone) and conventional (daily rFSH + GnRH antagonist). Secondly, to evaluate the frequency of ovarian hyperstimulation syndrome (OHSS), number of visits to the clinic and the clinical pregnancy rates.

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Friendly protocol for IVF seems to be safe (same risk of OHSS) and effective (oocyte mature and clinical pregnancy rate) in comparison to the conventional protocol in oocyte donors. The smaller number of visits to the clinic with the friendly protocol can be a great ally in times of social isolation due to the pandemic by COVID-19.