The significance of delayed suppression using buserelin acetate and recombinant follicle-stimulating hormone in a long protocol in vitro fertilization program.
OBJECTIVE
To determine whether the time taken to achieve ovarian suppression has an impact on ovarian responsiveness and the outcome of IVF-ET.


METHODS
Retrospective analysis.


METHODS
An assisted reproduction unit at a university center.


METHODS
Patients undergoing a long protocol of IVF-ET that included buserelin acetate therapy initiated on day 2 of the cycle and recombinant FSH.


METHODS
Patients were divided into two groups according to the duration of buserelin acetate therapy required to achieve pituitary and ovarian suppression (group 1 = 2 weeks, n = 172; group 2 = > or =3 weeks, n = 337).


METHODS
Number of recombinant FSH ampules administered, duration of ovarian stimulation (days), ovarian response, and IVF outcome.


RESULTS
The patients in group 2 had lower mean E2 levels after 5 days and 9 days of stimulation than the patients in group 1. The number of recombinant FSH ampules administered and the number of days of stimulation required were higher in group 2 than in group 1. These differences were prominent in the subgroups of older patients (> or =36 years) and patients who had no evidence of polycystic ovaries on ultrasound examination. The number of oocytes retrieved and fertilized, the cancelation rate, and the pregnancy rate were similar in the two groups.


CONCLUSIONS
Prolonged administration of a GnRH agonist to achieve suppression leads to a reduced ovarian response, particularly in women > or =36 years of age, but does not affect the success rate of IVF-ET.
Ravhon
A
A
Department of Reproductive Medicine and Science, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom. aravhon@bezeqint.net
Aurell
R
R
Lawrie
H
H
Margara
R
R
Winston
R M
RM
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D008423:Maternal Age; D008597:Menstrual Cycle / Q000187:drug effects / Q000502:physiology; D009865:Oocytes / Q000187:drug effects / Q000502:physiology; D010053:Ovary / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone; D002064:Buserelin