title: Microdose follicular phase gonadotropin-releasing hormone agonist (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization.
abstract: OBJECTIVE
  To compare an ovarian stimulation protocol using microdose follicular phase GnRH agonist (GnRH-a) and oral contraceptive (OC) pills to a luteal phase GnRH-a protocol.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  University affiliated IVF program.
  
  
  METHODS
  One hundred seventy patients who underwent IVF and ET in 1996.
  
  
  METHODS
  Patients were assigned to either a midluteal start of leuprolide acetate (LA) 1 mg/d, reduced to 0.5 mg/d after addition of gonadotropins (LUT), or OC pills until cycle day 0 followed by 20 microg of LA every 12 hours on cycle day 3 with addition of gonadotropins on cycle day 5 (MICRO).
  
  
  METHODS
  Number of FSH ampules, days of stimulation, peak E2, and number of oocytes retrieved.
  
  
  RESULTS
  There were no statistically significant differences in the main outcome measures between the two groups using an age-matched ANOVA. Clinical pregnancy rate per cycle start was not statistically different (LUT = 54%, and MICRO = 37%). The cancellation rate was significantly higher in the MICRO group (22.5% vs. 8.2%).
  
  
  CONCLUSIONS
  Given the higher cancellation rate in the microdose group, a randomized clinical trial is required to determine the possible benefit of a lower dose of GnRH-a in patients with normal ovarian function.
authors.affiliation: National Institute of Child Health and Development, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Leondires
authors.forename: M
authors.initials: M
authors.lastname: Escalpes
authors.forename: J H
authors.initials: JH
authors.lastname: Segars
authors.forename: R T
authors.initials: RT
authors.lastname: Scott
authors.forename: B T
authors.initials: BT
authors.lastname: Miller
mesh_terms: D000328:Adult; D004305:Dose-Response Relationship, Drug; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005498:Follicular Phase / Q000187:drug effects*; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011966:Receptors, LHRH / Q000819:agonists*; D012189:Retrospective Studies; D013268:Stimulation, Chemical
chemical_list: D011966:Receptors, LHRH