Clinical Efficacy of Reduced Dose GnRH Agonist Long Protocol for Controlled Ovarian Hyperstimulation in IVF-ET Patients with High Basal Serum FSH Level.
- Author:
Young Sik CHOI
1
;
Sun Mie KIM
;
Sang Don KIM
;
Dong Yun LEE
;
Byung Chul JEE
;
Seung Yup KU
;
Chang Suk SUH
;
Young Min CHOI
;
Jung Gu KIM
;
Shin Yong MOON
;
Seok Hyun KIM
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea.
- Publication Type:Original Article ; In Vitro
- Keywords:
In vitro fertilization and embryo transfer (IVF-ET);
Controlled ovarian hyperstimulation (COH);
GnRH agonist long protocol;
Reduced dose
- MeSH:
Embryo Transfer;
Embryonic Structures;
Estradiol;
Fertilization in Vitro;
Gonadotropin-Releasing Hormone*;
Gonadotropins;
Humans;
Oocytes;
Pregnancy Rate;
Progesterone;
Retrospective Studies
- From:Korean Journal of Obstetrics and Gynecology
2004;47(2):269-277
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: To evaluate the clinical efficacy of half-dose and further reduced dose GnRH agonist long protocols for controlled ovarian hyperstimulation (COH) in in vitro fertilization and embryo transfer (IVF-ET) patients with high basal serum FSH level. METHODS: One hundred and two IVF-ET cycles performed in 84 infertile patients with high basal serum FSH level (FSH>10.0 mIU/mL) were included in this retrospective study. Study subjects were assigned in two groups: continuous half-dose GnRH agonist long protocol (Group A, n=63) vs. further reduced dose GnRH agonist long protocol (Group B, n=39) from half-dose at the start of GnRH agonist to 1/3 or 1/4 dose after pituitary suppression. Exogenous FSH or hMG was administered for COH in step-down mode, 4 or less embryos were transferred, and intramuscular progesterone or 8% progesterone gel was used for the luteal support. RESULTS: Serum estradiol (E2) level on hCG day was significantly higher in Group B (1,318.3 +/- 1,120.4 vs. 2,054.9 +/- 1,773.5 pg/mL, p=0.015). The number of transferable embryos was also significantly higher in Group B (2.9 +/- 1.7 vs. 3.7 +/- 2.0, p=0.027). There was no statistically significant difference in the outcomes such as the dose of gonadotropins administered, the number of oocytes retrieved, and the clinical pregnancy rate. CONCLUSION: GnRH agonist long protocol with the reduced dose from half-dose at the start to 1/3 or 1/4 of dose after pituitary suppression may be more beneficial for COH in IVF-ET patients with high basal serum FSH level. Further prospective randomized controlled study in a larger scale will be necessary to confirm this findings.
