GnRH analogs: depot versus short formulations

Area of Science:

• Reproductive Endocrinology
• Assisted Reproductive Technology (ART)

Background:

• Gonadotropin-releasing hormone agonists (GnRH-a) are standard in controlled ovarian hyperstimulation (COH) for ART.
• Both short-acting and depot formulations of GnRH-a are available, with differing pituitary suppression profiles.

Purpose of the Study:

• To compare the efficacy of reduced-dose short GnRH-a protocols versus depot formulations in assisted reproduction.
• To evaluate the impact on ovarian response and IVF cycle outcomes, particularly in different patient populations.

Main Methods:

• Review of studies comparing short GnRH-a protocols with reduced doses against depot formulations.
• Analysis of outcomes in normally responding women versus poor responders undergoing ovarian stimulation.

Main Results:

• Reduced daily triptorelin (a GnRH-a) adequately suppresses the pituitary during stimulation.
• No significant improvement in IVF outcomes was observed for normally responding women using reduced short GnRH-a doses compared to depot formulations.
• Reduced short GnRH-a doses appeared to enhance ovarian response and overall results in poor responders.
• Shorter treatment durations and lower gonadotropin requirements were noted with low-dose short GnRH-a protocols.

Conclusions:

• Reduced-dose short GnRH-a protocols may be beneficial for poor responders in ART.
• These protocols offer potential economic advantages due to shorter treatment and reduced gonadotropin use.
• Consideration of reduced-dose short GnRH-a protocols is warranted, especially for specific patient groups.