Use of buserelin and low-dose human menopausal gonadotropin for in vitro fertilization in women at risk of ovarian hyperstimulation syndrome.
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.
Wada
I
I
Regional IVF Unit, St. Mary's Hospital, Whitworth Park, Manchester, UK.
Matson
P L
PL
Troup
S A
SA
Lieberman
B A
BA
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
D006062:Gonadotropins; D004958:Estradiol; D008596:Menotropins; D016729:Leuprolide; D002064:Buserelin