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Long-term down-regulation does not improve pregnancy rates in an in vitro fertilization program
F Fábregues1, J Balasch, M Creus
1Department of Obstetrics and Gynecology, Faculty of Medicine-University of Barcelona, Hospital Clinic i Provincial, Spain.
Fertility and Sterility
|July 11, 1998
Summary
Long-term down-regulation before IVF ovarian stimulation did not improve pregnancy rates. While serum E2 levels were higher with daily injections, outcomes like oocyte quality and pregnancy rates remained similar between groups.
Area of Science:
- Reproductive Endocrinology
- Assisted Reproductive Technologies
Background:
- Controlled ovarian stimulation is crucial for in vitro fertilization (IVF).
- Ovarian down-regulation aims to synchronize follicular development for improved IVF outcomes.
- Long-term down-regulation protocols are used to prepare patients for gonadotropin stimulation.
Purpose of the Study:
- To evaluate the impact of a 4-month down-regulation protocol using leuprolide acetate depot compared to a standard short-acting protocol.
- To assess the effects on ovarian response and IVF-embryo transfer (IVF-ET) outcomes.
Main Methods:
- Prospective randomized study involving 60 IVF patients.
- Two groups received either daily subcutaneous leuprolide acetate (group L) or monthly depot injections (group D) for 4 months prior to stimulation.
- Ovarian response and IVF cycle parameters were monitored.
Main Results:
- No significant differences were observed in ovarian stimulation days, follicular growth, or endometrial thickness.
- Group L showed higher serum estradiol (E2) levels despite higher gonadotropin doses in group D.
- Oocyte maturation (metaphase II) was significantly higher in group L, but overall pregnancy and implantation rates were similar between groups.
Conclusions:
- Long-term down-regulation with monthly leuprolide acetate depot injections does not enhance pregnancy rates in a general IVF population.
- Standard short-acting leuprolide acetate protocols appear equally effective for IVF outcomes.