Prospective randomized comparison of ovarian blockade with nafarelin versus leuprolide during ovarian stimulation with recombinant FSH in an ICSI program.
OBJECTIVE
A prospective study was conducted to compare the efficiency of ovarian blockade with nafarelin versus leuprolide in a population whose indication for assisted reproduction was the male factor


METHODS
A total of 238 patients were assigned at random to two types of treatment: Group I (119 aspirations), nafarelin (Synarel, Searle), 200 microg by the nasal route twice a day, and Group II (119 aspirations), leuprolide acetate (Lupron, Abbott), 0.5 mg by the subcutaneous route once a day. Both types of blockade were started during the 2nd phase (21st day of the menstrual cycle) and were continued until the day of HCG (5,000-10,000 IU). All patients received a fixed dose of recombinant FSH for 7 days and on the 8th day of stimulation the doses started to be adapted according to ovarian response.


RESULTS
Patients' age did not differ (p = 0.93) between Group 1 (34.1 +/- 3.79) and Group II (34 +/- 4.64). The number of oocytes retrieved from Group I (10.5 +/- 5.93) was also similar (p = 0.57) to that retrieved from Group II (10.2 +/- 6.36). In addition, there was no difference (p = 0.58) in the number of oocytes retrieved at Metaphase II between Group I (8.2 +/- 4.61) and Group II (7.9 +/- 5.2). Fertilization rates and embryo scores were similar (p = 0.81 and p = 0.25, respectively) for Group I (67.5% +/- 21.3 and 34.4% +/- 14.4) and Group II (68.1% +/- 23and32.2% +/- 14.7, respectively). Inaddition, pregnancy rates per puncture and per embryo transfer and implantation rates were similar for Group I (30.2, 31.3, and 16.2%, respectively) then compared with Group 11(24.4, 25.2, and 12.6%, respectively) (p = 0.38, p = 0.37, and p = 0.22, respectively).


CONCLUSIONS
Implantation and pregnancy rates per puncture and per embryo transfer are not statistically significant in the nafarelin group when compared with leuprolide group.
Franco
J G
JG
Center for Human Reproduction, Sinhá Junqueira Maternity Foundation, Ribeirão Preto, SP, Brazil. crh@highnet.com.br
Baruffi
R L
RL
Mauri
A L
AL
Petersen
C G
CG
Chufallo
J E
JE
Felipe
V
V
Garbellini
E
E
D000328:Adult; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology*; D005640:Follicle Stimulating Hormone / Q000494:pharmacology*; D006728:Hormones / Q000494:pharmacology; D006801:Humans; D016729:Leuprolide / Q000494:pharmacology*; D008297:Male; D017274:Nafarelin / Q000494:pharmacology*; D009865:Oocytes / Q000187:drug effects / Q000502:physiology; D010053:Ovary / Q000502:physiology; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000494:pharmacology; D020554:Sperm Injections, Intracytoplasmic
D005300:Fertility Agents, Female; D006728:Hormones; D011994:Recombinant Proteins; D017274:Nafarelin; D005640:Follicle Stimulating Hormone; D016729:Leuprolide