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Prospective study of a modified gonadotropin-releasing hormone agonist long protocol in an in vitro fertilization
K Pantos1, T Meimeth-Damianaki, T Vaxevanoglou
1Infertility Centre of Athens, Greece.
Objective:
To determine if pituitary suppression is still maintained if GnRH agonist (GnRH-a) is discontinued as gonadotropin stimulation is begun in a long protocol.
Design:
Prospective, randomized study.
Setting:
An outpatient IVF-GIFT program.
Patients:
One hundred seventy-three patients entering an IVF-GIFT program.
Interventions:
Gonadotropin-releasing hormone agonist in long protocol was either discontinued or continued as gonadotropin stimulation was begun.
Main Outcome Measures:
Luteinizing hormone (LH), E2, and P levels, egg numbers, fertilization rate, number of embryos transferred, day of gonadotropin stimulation, and pregnancy rates (PRs).
Results:
Pituitary suppression was maintained although GnRH-a was discontinued as gonadotropin stimulation was begun. No spontaneous LH surge was seen, and PRs were increased in the IVF patients.
Conclusion:
This study indicates that the advantages gained from use of GnRH-a in the long protocol are not compromised by its early discontinuation.