[Programmed stimulation for in vitro fertilization]

A programmed stimulation protocol for in vitro fertilisation was evaluated in order to perform oocytes aspiration from Tuesday to Friday only. For this purpose, norethisterone acetate (Primolut-Nor) was given in a daily dose of 10 mg for 10-25 days, starting on the 2nd day of the preceding cycle and ending on a Monday. The stimulation was started on the following Friday by administering daily 0.1 mg D-Trp-6-LHRH s. c. (Decapeptyl). In group A (preliminary study) the treatment with HMG 150 IU/d (Pergonal) was initiated two days later. In group B the treatment with HMG was individualised with respect to the initial dose and the starting point. 10 ultrasonographic, needle-guided, transvaginal aspirations were performed from January to March 1990 in Group A, 29 aspirations from April to December 1990 in Group B. Indication for IVF in all patients was tubal infertility. All aspirations were possible from Tuesday to Friday. In Group A 5 of 15 cycles (33%) had to be cancelled. A total of 53 oocytes (5.3 +/- 2.3 per aspiration) were retrieved. Cleavage per oocyte took place in 62%. There was no pregnancy. In Group B, the cancellation rate could be reduced to 3% (1/30 cycles; p less than 0.025). 227 oocytes were recovered (7.8 +/- 3.1 per aspiration; p less than 0.05) and there was a higher cleavage rate (74%, n.s.). The clinical pregnancy rate (with allowance for progressive introduction of freezing) increased to 30% per stimulation cycle (9/30, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)