[Hyperstimulation for in vitro fertilization with the "step-down" technique. Preliminary results from a prospective randomized study with and without LHRH agonists].
Twenty six normo-ovulatory patients < 38 years with tubal or idiopathic infertility and normal sperm were treated for IVF by FSH +/- hMG and randomized into four groups: with and without LHRH agonist, "step-up" or "step-down" stimulation. In the step down protocol, after 4 days with 4 amps plasmatic FSH reached its top level, then decreased. Despite reduction to only two amps, estradiol continued to increase in all the 5 women without agonist, whereas 3/7 with the long protocol were considered as low responders and stopped. The fertilization/cleavage rate was 69.2% in step-down and 45.7% in step-up (p < 0.04) with the short protocol, and respectively 65.6% and 41.9% (p < 0.03) with the long one. The pregnancy rate was equivalent in all groups.
Antoine
J M
JM
Service de gynécologie-obstétrique, Hôpital Tenon, Paris.
Salat-Baroux
J
J
Alvarez
S
S
Cornet
D
D
Firmin
C
C
Mandelbaum
J
J
Plachot
M
M
D000328:Adult; D002985:Clinical Protocols; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies
D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone
Hyperstimulation en vue de FIV selon la technique du "step-down". Résultats préliminaires d'une étude prospective randomisée avec ou sans agonistes de la LHRH.