Short term use of an LHRH agonist to treat poor responders entering an in-vitro fertilization programme

Seven patients who had previously responded poorly to stimulationwith clomiphene citrate (CC) and human menopausal gonadotrophin(HMG) and also exhibited high tonic urinary LH output (>0.25 IU/h) were given an LHRH agonist (500 µg/daily) ondays 1 to 3 of the menstrual cycle followed by exogenous gonadotrophinstimulation. During the latter stages of follicular developmentplasma and urinary LH output were significantly lower (P <0.01) than in the previous CC/MMG stimulated cycle. All sevenpatients had oocytes recovered, and embryos replaced. Threeout of these seven became pregnant. To conclude, the efficacyof short term LHRH agonist treatment is equivalent to presentlonger term modes of administration in reducing gonadotrophinsecretion and inhibiting the LH surge. The more widespread adoptionof this abbreviated protocol could improve the prognosis forpatients undergoing IVF in centres where facilities for intensiveendocrine monitoring are not available.