Short versus long gonadotropin-releasing hormone analogue suppression protocols for superovulation in patients > or = 40 years old undergoing intracytoplasmic sperm injection.
OBJECTIVE
To determine whether the short or long protocol for controlled ovarian hyperstimulation works better in older patients undergoing IVF.


METHODS
Controlled, randomized study.


METHODS
A single private IVF center.


METHODS
Two hundred twenty infertile women aged > or = 40 years undergoing IVF.


METHODS
At their first IVF cycle, the women were randomized into two study groups according to a computer-generated number sequence: 110 patients were treated with a long protocol, and the other 110 were treated with a short protocol for controlled ovarian hyperstimulation.


METHODS
Days of stimulation, E2 level at the day of hCG administration, amount of FSH administered, number of oocytes collected, number of embryos obtained, pregnancy rate, implantation rate.


RESULTS
Patients treated with a long protocol showed a significantly higher number of oocytes retrieved, a higher number of embryos obtained, and a higher pregnancy rate, both for cycle and transfer, compared with the short-protocol patients. The other parameters evaluated did not show any statistically significant differences.


CONCLUSIONS
Our study showed that the long protocol performed better than the short protocol in older women. Our findings demonstrated that flare-up in older women might be detrimental.
Sbracia
Marco
M
Center of Endocrinology and Reproductive Medicine, Rome, Italy. marcandrea@hotmail.com
Farina
Antonio
A
Poverini
Roberta
R
Morgia
Francesco
F
Schimberni
Mauro
M
Aragona
Cesare
C
D000328:Adult; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods* / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric; D013480:Superovulation / Q000187:drug effects*; D013997:Time Factors
D007987:Gonadotropin-Releasing Hormone