|
|||||
|
|
Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization |
|
| Authors: | Mark P. Leondires M.D. Mariabelle Escalpes M.D. James H. Segars M.D. Richard T. ScottJr. M.D. Bradley T. Miller M.D. |
| Affiliation: | a National Institute of Child Health and Human Development, National Institutes of Health, Wayne State University, Detroit, Michigan, USA b Reproductive Medicine Associates of New Jersey, Morristown, New Jersey USA c National Naval Medical Center, Bethesda, Maryland, USA |
| Abstract: | Objective: To compare an ovarian stimulation protocol using microdose follicular phase GnRH agonist (GnRH-a) and oral contraceptive (OC) pills to a luteal phase GnRH-a protocol. Design: Retrospective analysis. Setting: University affiliated IVF program. Patient(s): One hundred seventy patients who underwent IVF and ET in 1996. Intervention(s): Patients were assigned to either a midluteal start of leuprolide acetate (LA) 1 mg/d, reduced to 0.5 mg/d after addition of gonadotropins (LUT), or OC pills until cycle day 0 followed by 20 μg of LA every 12 hours on cycle day 3 with addition of gonadotropins on cycle day 5 (MICRO). Main Outcome Measure(s): Number of FSH ampules, days of stimulation, peak E2, and number of oocytes retrieved. Result(s): There were no statistically significant differences in the main outcome measures between the two groups using an age-matched ANOVA. Clinical pregnancy rate per cycle start was not statistically different (LUT = 54%, and MICRO = 37%). The cancellation rate was significantly higher in the MICRO group (22.5% vs. 8.2%). Conclusion(s): Given the higher cancellation rate in the microdose group, a randomized clinical trial is required to determine the possible benefit of a lower dose of GnRH-a in patients with normal ovarian function. |
| Keywords: | Microdose GnRH-a in vitro fertilization cost efficiency |
| 本文献已被 ScienceDirect 等数据库收录！ | |