title: Clinical outcome of using ganirelix acetate versus a 4-day follicular phase leuprolide acetate protocol in unselected women undergoing in vitro fertilization.
abstract: OBJECTIVE
  To compare the clinical outcome of controlled ovarian hyperstimulation (COH) in unselected patients undergoing IVF using multidose ganirelix acetate versus 4 days of administration of leuprolide acetate.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A fertility and IVF center.
  
  
  METHODS
  Two hundred forty-seven women who underwent COH-IVF between April 1, 1999, and January 30, 2001.
  
  
  METHODS
  Pituitary suppression according to a 4-day follicular phase leuprolide acetate protocol (236 women) or a multidose ganirelix acetate regimen (133 women).
  
  
  METHODS
  Amount of gonadotropin used, days of stimulation, cancellation rate, number of oocytes retrieved, implantation rate, and clinical pregnancy rate.
  
  
  RESULTS
  Compared with leuprolide acetate recipients, ganirelix recipients required significantly less gonadotropin and the mean day of hCG administration was 4 days earlier. Among women younger than 35 years of age, the implantation rate (15% vs. 6%) and the clinical pregnancy rate per initiated and transferred cycle (27% vs. 12% and 32% vs. 15%, respectively) were significantly higher in the ganirelix group than the leuprolide acetate group.
  
  
  CONCLUSIONS
  Compared with a 4-day leuprolide acetate protocol, COH-IVF using a multidose ganirelix acetate protocol reduces treatment duration and amount of gonadotropin used. In younger women, the latter protocol is associated with significantly better pregnancy and implantation rates.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, The Georgeanna and Howard Jones Service, Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. mnposada@epm.net.co
authors.forename: M Natalia
authors.initials: MN
authors.lastname: Posada
authors.forename: Nikos P
authors.initials: NP
authors.lastname: Vlahos
authors.forename: Marcus W
authors.initials: MW
authors.lastname: Jurema
authors.forename: Nabal J
authors.initials: NJ
authors.lastname: Bracero
authors.forename: Edward E
authors.initials: EE
authors.lastname: Wallach
authors.forename: Jairo E
authors.initials: JE
authors.lastname: Garcia
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004334:Drug Administration Schedule; D010064:Embryo Implantation / Q000502:physiology; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase / Q000502:physiology; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage*; D016014:Linear Models; D007986:Luteinizing Hormone / Q000097:blood; D015999:Multivariate Analysis; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide; C061018:ganirelix