Human menopausal gonadotropin versus recombinant follicle-stimulating hormone in normogonadotropic women down-regulated with a gonadotropin-releasing hormone agonist who were undergoing in vitro fertilization and intracytoplasmic sperm injection: a prospective randomized study.
OBJECTIVE
To evaluate clinical and endocrinological effects of intranasal (IN) vs. subcutaneous (SC) GnRH-a for pituitary down-regulation combined with hMG vs. rFSH.


METHODS
Prospective, randomized study.


METHODS
University hospital, IVF unit.


METHODS
Three hundred seventy-nine normogonadotropic women eligible for IVF or ICSI.


METHODS
Randomization to intranasal (IN) or SC GnRH-a and to hMG or rFSH.


METHODS
Oocytes retrieved, embryos developed, clinical pregnancy, and delivery rates. Serum hormone concentrations on stimulation days 1 (S1) and 8 (S8), and oocyte pick-up (OPU) day.


RESULTS
After randomization, four groups were formed: IN/hMG (n = 100), IN/FSH (n = 98), SC/hMG (n = 89), and SC/FSH (n = 92). Mean number of oocytes retrieved and of transferable and transferred embryos were similar in the four groups. Clinical pregnancy rate per started cycle was significantly higher in the IN/HMG group than in the SC/FSH group (P<.05) and was intermediate in the two remaining groups. Se-LH on S8 in the two SC groups was significantly lower than in the two IN groups. Se-E2 on S8 in the SC/FSH group was significantly lower than in the other three groups.


CONCLUSIONS
The clinical and endocrinological outcome in IVF and ICSI-treated normogonadotropic women is significantly influenced by mode of down-regulation as well as gonadotropin formulation.
Westergaard
L G
LG
Fertility Clinic, Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark. lw@trianglen.dk
Erb
K
K
Laursen
S B
SB
Rex
S
S
Rasmussen
P E
PE
D000281:Administration, Intranasal; D000328:Adult; D018929:Cell Culture Techniques / Q000379:methods; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007231:Infant, Newborn; D007279:Injections, Subcutaneous; D008596:Menotropins / Q000008:administration & dosage / Q000627:therapeutic use*; D009865:Oocytes / Q000166:cytology; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D020554:Sperm Injections, Intracytoplasmic
D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D005640:Follicle Stimulating Hormone