Cessation of gonadotropin-releasing hormone analogue (GnRH-a) upon down-regulation versus conventional long GnRH-a protocol in poor responders undergoing in vitro fertilization.
Fertil Steril
; 72(3): 406-11, 1999 Sep.
Article
en En
| MEDLINE
| ID: mdl-10519608
ABSTRACT
OBJECTIVE:
To determine whether a controlled ovarian hyperstimulation (COH) regimen that involves GnRH agonist (GnRH-a) discontinuation before administration of gonadotropins would benefit poor responders.DESIGN:
A prospective, randomized controlled trial.SETTING:
Hospital-based IVF Unit. PATIENT(S) Sixty-three patients with previous poor response to COH and/or high basal FSH level (> or =9 mIU/mL) undergoing 78 IVF-ET cycles. INTERVENTION(S) In both groups, administration of GnRH-a was started in the midluteal phase. Whereas in the study group (40 cycles), it ended before administration of gonadotropins, in controls (38 cycles) GnRH-a treatment was continued throughout the follicular phase. MAIN OUTCOME MEASURE(S) Ovarian stimulation patterns and IVF outcome. RESULT(S) A significantly higher cancellation rate was noted in the study group than in the controls (22.5% versus 5%, respectively). The new and control regimens resulted in similar stimulation characteristics and clinical pregnancy rates (11% versus 10.3%, respectively). In 13 patients with a basal FSH level that was not persistently high, the new regimen resulted in a significantly higher number of retrieved oocytes compared with the standard protocol (7.6+/-1.03 versus 4.0+/-0.68, respectively). CONCLUSION(S) Whereas for most low responders, the new COH regimen offers no further advantage, future prospective studies may demonstrate whether it can confer a benefit for a subset of patients with a basal FSH level that is not persistently high.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Inducción de la Ovulación
/
Fertilización In Vitro
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Buserelina
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Pamoato de Triptorelina
Tipo de estudio:
Clinical_trials
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Guideline
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Observational_studies
Límite:
Adult
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Female
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Humans
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Male
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Pregnancy
Idioma:
En
Revista:
Fertil Steril
Año:
1999
Tipo del documento:
Article
País de afiliación:
Israel
Pais de publicación:
EEUU
/
ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
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USA