Leuprolide acetate-prepared in vitro fertilization-gamete intrafallopian transfer cycles: efficacy versus controls and cost analysis.
OBJECTIVE
To evaluate the effect of gonadotropin-releasing hormone agonist (GnRH-a) when given through stimulation with gonadotropins versus stopping it as stimulation was initiated versus a control group unprepared in this manner. Also, to construct a cost analysis for this type of therapy in an in vitro fertilization-gamete intrafallopian transfer program (IVF-GIFT).


METHODS
Prospective, consecutive, randomized, with a control group.


METHODS
An out-patient IVF-GIFT program.


METHODS
One hundred new patients entering an IVF-GIFT program.


METHODS
In vitro fertilization or GIFT cycles with or without preparation (pituitary suppression) by GnRH-a administration in which suppression was continued or halted as gonadotropins were begun.


METHODS
Cancellation rates, ampules, and days of gonadotropin use, costs, estradiol (E2) level, egg numbers and quality, and pregnancy rates.


RESULTS
Stopping GnRH-a (leuprolide acetate) therapy as stimulation was begun did not lessen the suppressive effect in reduction of spontaneous luteinizing hormone surge as seen with continued use of agonist. In contrast, the control group had a 30.3% cancellation rate before ovum retrieval. The E2 and egg data among the groups were similar, but as expected, agonist use led to the need for more and longer duration of gonadotropin stimulation. Pregnancy rates were not different by group. Costs were approximately even by the third initiated cycle.
Corson
S L
SL
Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia.
Batzer
F R
FR
Gocial
B
B
Eisenberg
E
E
Huppert
L C
LC
Nelson
J R
JR
D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer / Q000191:economics; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008596:Menotropins / Q000627:therapeutic use; D011247:Pregnancy; D011336:Probability; D011446:Prospective Studies; D012099:Reproductive Techniques / Q000191:economics; D017329:Triptorelin Pamoate / Q000031:analogs & derivatives*; D014481:United States
D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; C019176:Tryptal; D008596:Menotropins