title: Use of buserelin and low-dose human menopausal gonadotropin for in vitro fertilization in women at risk of ovarian hyperstimulation syndrome.
abstract: OBJECTIVE
  The purpose of the present study was (i) to assess the value of using a low dose of hMG (75 IU/day) to achieve ovarian stimulation in women who have previously shown an exaggerated response to a standard dose of 150 IU human menopausal gonadotropin/day in a desensitization (group I) or flare-up (group II) protocol and (ii) to determine whether the choice of GnRH-a regimen in a subsequent cycle, namely, a desensitization or flare-up protocol, influenced the effectiveness of the low dose of hMG.
  
  
  RESULTS
  In group I, 75% (12/16) and 57% (8/14) of the subsequent desensitization and flare-up protocols, respectively, were cancelled because of inadequate ovarian response. Similarly, the cancellation rates in group II were 10 of 10 and 7 of 11 (64%), respectively. The total cancellation rate (groups I and II together) with the desensitization protocol was higher than that using the flare-up protocol (P < 0.05).
  
  
  CONCLUSIONS
  The simple use of a reduced dose of hMG (75 IU/day) for subsequent in vitro fertilization in women to minimize the risk of the development of ovarian hyperstimulation is of limited benefit since a large proportion then shows an inadequate response. This is particularly pronounced with a subsequent desensitization protocol which does not utilize endogenous gonadotropins to initiate follicular development.
authors.affiliation: Regional IVF Unit, St. Mary's Hospital, Whitworth Park, Manchester, UK.
authors.forename: I
authors.initials: I
authors.lastname: Wada
authors.forename: P L
authors.initials: PL
authors.lastname: Matson
authors.forename: S A
authors.initials: SA
authors.lastname: Troup
authors.forename: B A
authors.initials: BA
authors.lastname: Lieberman
mesh_terms: D000328:Adult; D002064:Buserelin / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008596:Menotropins / Q000009:adverse effects / Q000627:therapeutic use*; D008597:Menstrual Cycle; D016471:Ovarian Hyperstimulation Syndrome / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011863:Radioimmunoassay; D012307:Risk Factors
chemical_list: D006062:Gonadotropins; D004958:Estradiol; D008596:Menotropins; D016729:Leuprolide; D002064:Buserelin