A prospective randomized comparison between long and discontinuous-long protocols of gonadotropin-releasing hormone agonist for in vitro fertilization.
OBJECTIVE
To investigate the efficacy of a discontinuous-long protocol in an IVF program.


METHODS
Prospective randomized study.


METHODS
University hospital.


METHODS
One hundred thirty-seven IVF cycles of 92 patients in an outpatient IVF program from April 1995 to December 1995.


METHODS
In the discontinuous-long protocol group (n = 68), GnRH agonist (GnRH-a) was administered from the luteal phase until cycle day 7, when pure FSH administration was begun. In the long protocol group (n = 69), GnRH-a was administered until the day before hCG administration.


METHODS
Serum LH and ovarian steroid hormone levels, and IVF outcome.


RESULTS
The period and the total dosage of hMG were increased in the discontinuous-long protocol group. Although the fertilization rate was similar under both protocols, the number of embryos transferred was smaller and the cancellation rate was higher in the discontinuous-long protocol group because of the greater failure of oocyte retrieval and fertilization. Serum E2 levels in the late follicular phase were lower in the discontinuous-long protocol group.


CONCLUSIONS
Early discontinuation of GnRH-a is not beneficial because of its adverse effects on follicular development.
Fujii
S
S
Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Aomori, Japan.
Sagara
M
M
Kudo
H
H
Kagiya
A
A
Sato
S
S
Saito
Y
Y
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004715:Endometriosis; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000627:therapeutic use; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007247:Infertility, Female; D007248:Infertility, Male; D008297:Male; D008597:Menstrual Cycle; D009865:Oocytes / Q000166:cytology; D011446:Prospective Studies
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone