title: Self-control study on reduced-dose depot versus daily administration of gonadotrophin-releasing hormone agonists for pituitary desensitization in in vitro fertilization cycles.
abstract: OBJECTIVE
  Our aim was to analyze the effect of reducing the dose of depot gonadotrophin-regulating hormone-agonist (GnRH-a) to 1.0 mg on pituitary desensitization and clinical outcome of in vitro fertilization and embryo transfer cycles.
  
  
  METHODS
  This retrospective self-control study was conducted on 143 patients who underwent repeated long-protocol treatment from 1 January 2011 to 31 May 2012 at our hospital. Of the 143 patients, 64 received reduced-dose depot (1.0 mg diphereline depot) GnRH-a for the first cycle and short-acting GnRH-a (0.05 mg diphereline) for the second cycle, while 79 patients received short-acting GnRH-a for the first cycle and reduced-dose depot GnRH-a for the second cycle.
  
  
  RESULTS
  The serum follicle-stimulating hormone, luteinizing hormone and estradiol levels on the day of gonadotrophin initiation were significantly higher in the short-acting group compared with the long-acting group. Both number of days of gonadotrophin stimulation and gonadotrophin doses were significantly higher in the short-acting group. On the day of human chorionic gonadotrophin administration, the serum estradiol level was significantly higher while the progesterone level was significantly lower in the short-acting group. There were no significant differences with regard to the number of retrieved oocytes, fertilization rate, number of transferred embryos, clinical pregnancy rate, implantation rate, and early pregnancy loss rate between the two groups. However, the oocyte maturation rate was significantly higher in the long-acting group.
  
  
  CONCLUSIONS
  Reduced-dose depot GnRH-a can be successfully used for pituitary desensitization in in vitro fertilization and embryo transfer. Deeper downregulation with reduced-dose depot GnRH-a indicates that the optimal dose of GnRH-a warrants future study.
authors: Reproductive Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Jun
authors: J
authors: Gao
authors: Yan-Wen
authors: YW
authors: Xu
authors: Ben-Yu
authors: BY
authors: Miao
authors: Can-Quan
authors: CQ
authors: Zhou
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists*; D006784:Hospitals, Teaching; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D010902:Pituitary Gland / Q000187:drug effects*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013618:Tachyphylaxis
chemical_list: D003692:Delayed-Action Preparations; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone
keywords: diphereline; gonadotrophin-releasing hormone agonist; in vitro fertilization; pituitary downregulation; self-control study