An improvement in the embryo quality and pregnancy rate by the pulsatile administration of human menopausal gonadotropin in patients with previous unsuccessful in vitro fertilization attempts.
OBJECTIVE
To examine whether the pulsatile administration of hMG improves IVF outcomes in patients with previous unsuccessful attempts using IM injections of hMG.


METHODS
A prospective randomized study.


METHODS
In vitro fertilization program at a university hospital.


METHODS
Eighty-eight endocrine-normal ovulatory women under 40 years of age, with normal male partners and a history of unsuccessful IVF treatment by the IM administration of hMG.


METHODS
Patients were assigned randomly to receive either IM (bolus group) or pulsatile administration of hMG (pulsatile group) after pituitary desensitization by a GnRH agonist.


METHODS
The proportion of retrieved oocytes with a polar body, the number of fertilized oocytes and embryos, the proportion of morphologically superior embryos, and the rate of pregnancy per initiated cycle were compared.


RESULTS
The proportion of retrieved oocytes with a polar body and the number of fertilized oocytes and embryos were similar in both groups. Significantly more embryos had superior morphology in the pulsatile group (77%) than the bolus group (52%). The rates of overall and clinical pregnancy per initiated cycle were significantly higher in the pulsatile group (39% and 30%, respectively, n = 44) than in the bolus group (18% and 11%, respectively, n = 44).


CONCLUSIONS
In women with failed IVF attempts using IM administration of hMG, the pulsatile administration of hMG produces superior embryos and, hence, a higher pregnancy rate.
Jinno
M
M
Department of Obstetrics and Gynecology, School of Medicine, Kyorin University, Tokyo, Japan.
Ubukata
Y
Y
Satou
M
M
Katsumata
Y
Y
Yoshimura
Y
Y
Nakamura
Y
Y
D000328:Adult; D004622:Embryo, Mammalian; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008596:Menotropins / Q000008:administration & dosage*; D011247:Pregnancy / Q000706:statistics & numerical data*; D011446:Prospective Studies; D017211:Treatment Failure
D005300:Fertility Agents, Female; D008596:Menotropins