Short-term luteinizing hormone-releasing hormone agonist treatment: prospective trial of a novel ovarian stimulation regimen for in vitro fertilization.
Over a period of 4 months, 262 infertile couples participated in a prospective pseudorandom trial of a novel short-term luteinizing hormone-releasing hormone/human menopausal gonadotropin (LH-RH/hMG) treatment; the short-Buserelin-gonadotropin (Hoechst, Hounslow, United Kingdom) regimen. Patients treated with the short-Buserelin-gonadotropin regimen had a significantly higher likelihood of achieving pregnancy than patients treated with the standard clomiphene citrate (CC)/hMG regimen (respectively, 35.5% and 18% per treatment cycle). A significantly higher number of eggs were collected after short-Buserelin-gonadotropin treatment than CC/hMG, but the proportion of patients having a given number of embryos replaced was similar in the two groups. The short-Buserelin-gonadotropin-treated patients were distinguished from the CC/hMG-treated group by significantly lower levels of LH in the late follicular phase and a lower plasma level of estradiol. A detrimental relationship between elevated endogenous LH secretion and failure of implantation has been established. The nature of the short-Buserelin-gonadotropin regimen provokes high levels of endogenous gonadotropin secretion in the early follicular phase and induces a suppression of gonadotropin secretion in the late follicular phase. This may be the physiologic basis of the greater implantation rate after short-Buserelin-gonadotropin treatment than is seen with conventional CC/hMG treatment.
Macnamee
M C
MC
Bourn Hall Clinic, Bourn, United Kingdom.
Howles
C M
CM
Edwards
R G
RG
Taylor
P J
PJ
Elder
K T
KT
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D007246:Infertility / Q000628:therapy; D007986:Luteinizing Hormone / Q000097:blood / Q000652:urine; D008596:Menotropins / Q000627:therapeutic use; D010053:Ovary / Q000503:physiopathology*; D011247:Pregnancy; D011446:Prospective Studies; D013268:Stimulation, Chemical
D002996:Clomiphene; D008596:Menotropins; D007986:Luteinizing Hormone; D002064:Buserelin