The use of long-acting gonadotropin-releasing hormone agonist (GnRH-a; decapeptyl) and gonadotropins versus short-acting GnRH-a (buserelin) and gonadotropins before and during ovarian stimulation for in vitro fertilization (IVF).
The efficiency of two ovarian stimulation protocols using different gonadotropin-releasing hormone agonists (GnRH-a) for in vitro fertilization (IVF) was examined and compared with human menopausal gonadotropin (hMG)-only stimulation. Fifty-four patients who had 57 aspiration cycles were treated with protocol 1, which consisted of long-acting GnRH-a D-Trp6 (Decapeptyl Depot) and hMG. Protocol 2 entailed intranasal administration of short-acting GnRH-a (Buserelin) and human menopausal gonadotropin (hMG) in 66 women who underwent 70 aspiration cycles. Fifty-five patients who had 59 ovum pickups (OPU) treated with hMG only served as a control. No differences were observed in cycle parameters and hormonal concentrations among the three groups. The total clinical pregnancy rates per OPU for patients receiving protocols 1 and 2 were 12.3 and 27.1%, respectively (P less than 0.05). The pregnancy loss was significantly lower in protocol 2 than in protocol 1 (26.3 versus 71.4%; P less than 0.05). Our data show superiority of short-acting GnRH-a over the long-acting agents in achievement of pregnancy and its outcome, though neither was significantly different from the hMG-only protocol.
Gonen
Y
Y
Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.
Dirnfeld
M
M
Goldman
S
S
Koifman
M
M
Abramovici
H
H
D000328:Adult; D002064:Buserelin / Q000494:pharmacology / Q000592:standards*; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000592:standards; D006062:Gonadotropins / Q000494:pharmacology / Q000592:standards*; D006801:Humans; D008186:Luteolytic Agents / Q000494:pharmacology / Q000592:standards*; D008596:Menotropins / Q000592:standards; D010053:Ovary / Q000187:drug effects*; D010062:Ovulation Induction; D011247:Pregnancy / Q000187:drug effects; D013997:Time Factors; D017329:Triptorelin Pamoate
D003692:Delayed-Action Preparations; D006062:Gonadotropins; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D002064:Buserelin