A controlled study of gonadotropin-releasing hormone agonist (buserelin acetate) for folliculogenesis in routine in vitro fertilization patients.
OBJECTIVE
To determine if gonadotropin-releasing hormone agonist (GnRH-a) and gonadotropin therapy could improve folliculogenesis and pregnancy rates (PRs) in women with a previously satisfactory response to clomiphene citrate and human menopausal gonadotropin (hMG).


METHODS
Randomized prospective study.


METHODS
Assisted reproduction clinic.


METHODS
One hundred fifty-seven women were randomized to receive either hMG alone or the GnRH-a buserelin acetate 600 microgram/d or buserelin acetate 1,200 microgram/d plus hMG.


RESULTS
Compared with hMG alone, pretreatment with buserelin acetate significantly increased the PR per cycle started by preventing a premature luteinizing hormone rise and thereby reducing the number of abandoned cycles. There was, however, no difference between the number of follicles aspirated, oocytes obtained, or fertilization rates between groups. Furthermore, agonist therapy significantly increased both the dose of hMG required and the duration of stimulation.


CONCLUSIONS
The routine use of GnRH-a in in vitro fertilization programs must be questioned.
Polson
D W
DW
Monash IVF Programme, Infertility Medical Centre, Epworth Hospital, Richmond, Victoria, Australia.
MacLachlan
V
V
Krapez
J A
JA
Wood
C
C
Healy
D L
DL
D002064:Buserelin / Q000494:pharmacology*; D002996:Clomiphene / Q000494:pharmacology; D015536:Down-Regulation; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer; D007987:Gonadotropin-Releasing Hormone / Q000502:physiology*; D006801:Humans; D008596:Menotropins / Q000494:pharmacology; D006080:Ovarian Follicle / Q000502:physiology*; D011446:Prospective Studies
D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D008596:Menotropins; D002064:Buserelin