Ovarian response and follicular development for single-dose and multiple-dose protocols for gonadotropin-releasing hormone antagonist administration.
OBJECTIVE
To determine the efficiency of a single-dose and a multiple-dose protocol for GnRH antagonist administration.


METHODS
Randomized clinical trial.


METHODS
University hospital, tertiary medical center.


METHODS
Sixty-one patients undergoing controlled ovarian stimulation (COS) and IVF/ICSI.


METHODS
COS with either a multiple-dose (MD) or a single-dose (SD) protocol for GnRH antagonist (cetrorelix) administration, or with a long protocol (LP) for GnRH agonist (buserelin) administration, followed by oocyte retrieval, IVF/ICSI, and embryo transfer.


METHODS
Follicular development and serum levels of E2 and LH.


RESULTS
The SD protocol for cetrorelix was associated with a more reduced level of follicular development, lower levels of serum estradiol on the day of HCG administration, and a more reduced number of zygotes than the LP for buserelin. The pregnancy and implantation rates did not differ significantly for the three study groups.


CONCLUSIONS
The MD and SD GnRH antagonist protocols were effective for preventing LH surge and appear to elicit an equivalent pregnancy rate to that corresponding to a LP GnRH agonist. In terms of follicular development, the SD protocol requires further modification, including flexible scheduling or possibly a small reduction of the dosage of the administered cetrorelix.
Lee
Tsung-Hsien
TH
Department of Obstetrics and Gynecology, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
Wu
Ming-Yih
MY
Chen
Hsin-Fu
HF
Chen
Mei-Jou
MJ
Ho
Hong-Nerng
HN
Yang
Yu-Shih
YS
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods / Q000706:statistics & numerical data; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects* / Q000254:growth & development; D010062:Ovulation Induction / Q000379:methods* / Q000706:statistics & numerical data; D011247:Pregnancy; D018873:Pregnancy Rate
D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix