title: Comparison of two different starting multiple dose gonadotropin-releasing hormone antagonist protocols in a selected group of in vitro fertilization-embryo transfer patients.
abstract: OBJECTIVE
  To compare the efficacy of two starting protocols of multiple dose GnRH antagonists (GnRH-a).
  
  
  METHODS
  Prospective randomized controlled study.
  
  
  METHODS
  In vitro fertilization-embryo transfer program at the Instituto Valenciano de Infertilidad, Valencia, Spain.
  
  
  METHODS
  One hundred nine patients undergoing controlled ovarian hyperstimulation (COH) with recombinant gonadotropins and GnRH-a (0.25 mg/d).
  
  
  METHODS
  Patients started GnRH-a administration on stimulation day 6 (group 1) or when the leading follicle reached a mean diameter of 14 mm (group 2).
  
  
  METHODS
  Implantation and pregnancy rates; serum E(2) and LH levels during ovarian stimulation; days of stimulation and GnRH-a administration.
  
  
  RESULTS
  Days needed for ovarian stimulation were similar in both groups but there was a significant difference when comparing days of GnRH-a administration. Serum E(2) and LH followed similar curves in both groups. Implantation and pregnancy rates were 23.7% and 44.4 % in group 1 and 28.6% and 50.9 % in group 2 (P=not significant [NS]).
  
  
  CONCLUSIONS
  The efficacy of the two starting protocols of the multiple dose GnRH-a evaluated in this study is similar; however, this remark can only be drawn for a selected group of patients.
authors.affiliation: Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Escudero
authors.forename: Ernesto
authors.initials: E
authors.lastname: Bosch
authors.forename: Juana
authors.initials: J
authors.lastname: Crespo
authors.forename: Carlos
authors.initials: C
authors.lastname: Simón
authors.forename: José
authors.initials: J
authors.lastname: Remohí
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellicer
mesh_terms: D000328:Adult; D004334:Drug Administration Schedule; D010064:Embryo Implantation; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000628:therapy*; D007986:Luteinizing Hormone / Q000097:blood; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000008:administration & dosage; D014463:Ultrasonography
chemical_list: D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone