Trial of support treatment with human chorionic gonadotrophin in the luteal phase after treatment with buserelin and human menopausal gonadotrophin in women taking part in an in vitro fertilisation programme.
OBJECTIVE
To evaluate the effect of support with human chorionic gonadotrophin in the luteal phase in women taking part in an in vitro fertilisation programme after buserelin and human menopausal gonadotrophin were used to hyperstimulate their ovaries.


METHODS
Controlled group comparison.


METHODS
Outpatient department of a private hospital.


METHODS
115 Women with indications for in vitro fertilisation, all of whom had at least one embryo transferred.


METHODS
After suppression of the pituitary with buserelin the ovaries of all the women were stimulated with human menopausal gonadotrophin on day 4 of the luteal phase. Human chorionic gonadotrophin (10,000 IU) was given to induce ovulation, and oocytes were recovered 34 hours later. Embryos were transferred 46 to 48 hours after insemination. Women who had received the 10,000 IU of human chorionic gonadotrophin on a date that was an uneven number (n = 61) were allocated to receive support doses of 2500 IU human chorionic gonadotrophin three and six days after that date. The remaining 54 women did not receive hormonal support.


METHODS
Determination of the rates of pregnancy. MEASUREMENTS and main results--Support with human chorionic gonadotrophin did not significantly alter the progesterone or oestradiol concentrations in the early or mid-luteal phase. The mean (range) progesterone concentrations in the late luteal phase in women who did not become pregnant were, however, significantly higher in those who received support (16(9-110) nmol/l nu 8(4-46) nmol/l), and the luteal phase was significantly longer in this group (14 days nu 12 days). The rate of pregnancy was significantly higher in the women who received support than in those who did not (25/61 nu 8/54).


CONCLUSIONS
When buserelin and human menopausal gonadotrophin are used to hyperstimulate ovaries support with human chorionic gonadotrophin in the luteal phase has a beneficial effect on in vitro fertilisation.
Smith
E M
EM
Department of Human Reproduction and Obstetrics, Princess Anne Hospital, University of Southampton.
Anthony
F W
FW
Gadd
S C
SC
Masson
G M
GM
D000328:Adult; D000553:Ambulatory Care; D002064:Buserelin / Q000627:therapeutic use*; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase; D008596:Menotropins / Q000627:therapeutic use*; D010053:Ovary / Q000187:drug effects; D010060:Ovulation / Q000187:drug effects; D013997:Time Factors
D006063:Chorionic Gonadotropin; D008596:Menotropins; D002064:Buserelin