title: Comparison between depot and standard release triptoreline in in vitro fertilization: pituitary sensitivity, luteal function, pregnancy outcome, and perinatal results.
abstract: OBJECTIVE
  To compare the effects of depot and standard release form of triptoreline in superovulation induction in IVF programs.
  
  
  METHODS
  One hundred ninety-six patients undergoing IVF were randomized between two treatment groups. Pituitary desensitization was obtained in group 1 (102 patients) with a single IM injection of 3.75 mg D-Trp-6-luteinizing hormone-releasing hormone (LH-RH) and, in group 2 (94 patients), with daily SC administration of 0.1 mg D-Trp-6-LH-RH. In a subgroup of 11 patients, a series of GnRH tests was performed to investigate pituitary desensitization and, in another subgroup of 12 patients, a study of luteal phase steroid profile was performed. In an additional 23 patients, a series of GnRH tests were performed to investigate pituitary desensitization during the late follicular and midluteal phases.
  
  
  RESULTS
  No differences were found in the time necessary to reach desensitization (11.3 +/- 1.03 versus 11.3 +/- 1.45 days; mean +/- SEM), whereas resumption of pituitary activity takes place in 7 days after the discontinuation of the daily form and in about 2 months after discontinuation of the depot form. No differences were found in the duration of stimulation, number of FSH ampules, E2 levels, and number of follicles (11.7 +/- 0.68, versus 12.2 +/- 0.68) on hCG administration day and the total oocytes collected (9.1 +/- 0.6 versus 9.2 +/- 0.64). Oocyte quality, percentage of fertilization and cleavage, pregnancy rate per transfer (28.7% versus 25.6%), and miscarriages (about 30%) were similar in the two protocols. No difference was found in hormonal levels during the luteal phase. In both groups there was a high incidence of multiple pregnancy.
  
  
  CONCLUSIONS
  Comparable results can be achieved with both long-acting and standard-release forms of GnRH analogs in patients undergoing assisted reproduction in terms of follicular stimulation and abortion rates despite differences in the duration of pituitary suppression.
authors.affiliation: Department of Reproductive Physiology and Pathology, University of Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Porcu
authors.forename: L
authors.initials: L
authors.lastname: Dal Prato
authors.forename: R
authors.initials: R
authors.lastname: Seracchioli
authors.forename: R
authors.initials: R
authors.lastname: Fabbri
authors.forename: M
authors.initials: M
authors.lastname: Longhi
authors.forename: C
authors.initials: C
authors.lastname: Flamigni
mesh_terms: D000328:Adult; D003338:Corpus Luteum / Q000502:physiology*; D003692:Delayed-Action Preparations; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase; D010062:Ovulation Induction; D010902:Pituitary Gland / Q000187:drug effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013480:Superovulation; D017329:Triptorelin Pamoate / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D003692:Delayed-Action Preparations; D017329:Triptorelin Pamoate