Prospective comparison of short and long GnRH agonist protocols using recombinant gonadotrophins for IVF/ICSI...

This is a prospective comparative study investigating cost and effectiveness of IVF/ intracytoplasmic sperm injection (ICSI) treatments after stimulation with recombinant gonadotrophins following either the short or long gonadotrophin-releasing hormone (GnRH) agonist protocol. Patients in the short protocol (n = 120) were administered buserelin nasal sprays from day 2 of the menstrual cycle and recombinant FSH from day 5. Patients in the long protocol (n = 120) were administered buserelin from the previous mid-luteal phase and recombinant FSH after achieving down-regulation. The average age and basal FSH concentrations of both groups were similar. The serum LH concentrations during ovarian stimulation were significantly higher with the short protocol. The total cost of recombinant gonadotrophins (US$527 +/- 184 versus US$795 +/- 244, P < 0.001) was significantly lower in the short protocol, but there was no significant difference in delivery rates (47.5 versus 36.7%) between the short and long protocols. LH flare-up during the short protocol does not seem to impair the treatment outcome. Using recombinant gonadotrophins, the short GnRH agonist protocol is an effective and cheaper choice for IVF/ICSI treatments.