title: A randomized prospective study of early follicular or midluteal initiation of long protocol gonadotropin-releasing hormone in an in vitro fertilization program.
abstract: OBJECTIVE
  To determine the optimum menstrual cycle time to initiate a long-protocol gonadotropin-releasing hormone agonist (GnRH-a) down-regulation regimen before hMG stimulation before IVF.
  
  
  METHODS
  Randomized, prospective, single, first cycle study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Eighty-six infertile couples undergoing IVF-ET attempt under rules for Ireland.
  
  
  METHODS
  Gonadotropin-releasing hormone agonist administered intranasally from day 1 or 21 of menstrual cycle. Human menopausal gonadotropin commenced when pituitary down-regulation was confirmed.
  
  
  METHODS
  Ovarian response, cancellation, fertilization, and pregnancy rates.
  
  
  RESULTS
  No significant differences found between day 1 and day 21 initiation. But starting on day 1 is more easily recognizable by patients and avoids the possibility of administering GnRH-a in the presence of an unsuspected pregnancy.
  
  
  CONCLUSIONS
  Both follicular and luteal phase initiation of GnRH-a long-protocol down-regulation are equally efficacious. In our clinical context, patients and management favor commencing on day 1.
authors.affiliation: Human Assisted Reproduction, Ireland.
authors.forename: U
authors.initials: U
authors.lastname: Kondaveeti-Gordon
authors.forename: R F
authors.initials: RF
authors.lastname: Harrison
authors.forename: C
authors.initials: C
authors.lastname: Barry-Kinsella
authors.forename: A C
authors.initials: AC
authors.lastname: Gordon
authors.forename: L
authors.initials: L
authors.lastname: Drudy
authors.forename: E
authors.initials: E
authors.lastname: Cottell
mesh_terms: D000328:Adult; D002064:Buserelin / Q000494:pharmacology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008596:Menotropins / Q000494:pharmacology; D008597:Menstrual Cycle / Q000187:drug effects*; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D008596:Menotropins; D002064:Buserelin