A novel method of ovarian stimulation for in vitro fertilization: bromocriptine-rebound method.
OBJECTIVE
To examine whether a new method of ovarian stimulation, bromocriptine-rebound method, improves IVF outcomes compared with the conventional long protocol of GnRH agonist and hMG regimen.


METHODS
A prospective clinical trial.


METHODS
In vitro fertilization program at a university hospital.


METHODS
Endocrine-normal ovulatory women less than 40 years of age, with normal male partners and previous failed IVF-ET using long protocol.


METHODS
Patients were assigned to either bromocriptine-rebound method (group 1) or long protocol (group 2). The bromocriptine-rebound method was the same as the long protocol, except that bromocriptine was administered daily from day 4 of the preceding cycle until 7 days before hMG stimulation.


METHODS
The number of cleaved and morphologically superior embryos, pregnancy rate per oocyte pick-up, and serum PRL concentrations during administrations of hMG.


RESULTS
Significantly more embryos were cleaved and had superior morphology in group 1 than group 2. Clinical and ongoing pregnancy rates per oocyte pick-up were significantly higher in group 1 (42% and 38%, respectively) than group 2 (24% and 21%, respectively). The mean PRL concentration was significantly higher in the group 1 than group 2. A significant correlation between the number of superior embryos and PRL concentrations was observed in group 1, but not in group 2.


CONCLUSIONS
The bromocriptine-rebound method enhanced embryonic development, resulting in an increased pregnancy rate compared with the long protocol.
Jinno
M
M
Kyorin University, Tokyo, Japan.
Yoshimura
Y
Y
Ubukata
Y
Y
Nakamura
Y
Y
D000328:Adult; D001971:Bromocriptine / Q000494:pharmacology*; D005314:Embryonic and Fetal Development / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000494:pharmacology; D006727:Hormone Antagonists / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008596:Menotropins / Q000494:pharmacology; D009866:Oogenesis / Q000187:drug effects / Q000502:physiology; D017063:Outcome Assessment, Health Care; D010053:Ovary / Q000187:drug effects / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies
D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D001971:Bromocriptine; D008596:Menotropins; D011388:Prolactin