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A prospective, randomized controlled trial comparing the efficacy of recombinant follicle-stimulating hormone in
A Ravhon1, H Lawrie, A Ellenbogen
1Wolfson Family Clinic and Flick Laboratories, Department of Reproductive Medicine and Science, Imperial College School of Medicine, Hammersmith Hospital, London, UK. aravhon@bezeqint.net
Objective:
To compare the following IVF protocols: a short protocol and long protocols starting on day 2 or day 21. All protocols used recombinant FSH (rFSH) for ovarian stimulation.
Design:
Prospective, randomized study.
Setting:
An assisted reproduction unit at a university center.
Patient(S):
Patients undergoing IVF (n = 150) were treated according to one of the three treatment protocols allocated by a random method.
Intervention(S):
All patients used buserelin acetate and rFSH. Patients began the long protocol on day 2 (group 1) or day 21 (group 2) of the cycle. Patients in group 3 began the short protocol on day 2 of the cycle.
Main Outcome Measure(S):
Ovarian response, implantation rates, and pregnancy rates (PRs).
Result(S):
Patients treated with the short protocol (group 3) were stimulated in a shorter time, required less rFSH, and achieved higher E(2) levels. The numbers of follicles, oocytes, and embryos were similar in all three groups. The implantation rates were similar in groups 1 and 2 (11.8% and 13.3%, respectively), and both were higher than in group 3 (4.1%). Clinical PRs per oocytes retrieved were 19.6%, 18.6%, and 8.3% in groups 1, 2, and 3, respectively.
Conclusion(S):
The implantation rate was significantly higher with the long protocols than with the short protocol, with a tendency for a higher PR as well.