A protocol using a low dose of gonadotrophin-releasing hormone agonist might be the best protocol for patients with high follicle-stimulating hormone concentrations on day 3.
We studied 98 in-vitro fertilization (IVF) patients with a high basal follicle stimulating hormone (FSH; >6.5 IU/l) concentration on day 3 who were treated with a low dose gonadotrophin-releasing hormone agonist (GnRHa) protocol and who had received in the previous 6 months a long protocol with GnRHa in a depot formula. The evaluation was made using the previous IVF cycle of the same patient as a control. The mean +/- SD age of the patients was 34.1+/-4.2 years. The use of a low dose agonist protocol ended with significantly less ampoules (37.5 versus 46.1), a shorter duration of stimulation (10.7 versus 12.3 days), a higher oestradiol concentration on day 8 (1068 versus 495 pg/ml), a higher number of mature oocytes (5.9 versus 4.4) and a higher number of good quality embryos (3.3 versus 2.3). The cancellation rate was lower (11 versus 24%). A GnRHa low dose protocol may be the protocol of choice for patients with high FSH concentrations on day 3. Larger randomized studies are needed to confirm these data.
Olivennes
F
F
Department of Obstetrics and Gynecology, A Belcere Hospital, 157 Rue de la Porte de Trivaux, 92140 Clamart, France.
Righini
C
C
Fanchin
R
R
Torrisi
C
C
Hazout
A
A
Glissant
M
M
Fernandez
H
H
Frydman
F
F
D002985:Clinical Protocols; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods; D017329:Triptorelin Pamoate / Q000008:administration & dosage* / Q000627:therapeutic use
D003692:Delayed-Action Preparations; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone