OBJECTIVE: To compare the efficacy of two starting protocols of multiple dose GnRH antagonists (GnRH-a). DESIGN: Prospective randomized controlled study. SETTING: In vitro fertilization-embryo transfer program at the Instituto Valenciano de Infertilidad, Valencia, Spain. PATIENT(S): One hundred nine patients undergoing controlled ovarian hyperstimulation (COH) with recombinant gonadotropins and GnRH-a (0.25 mg/d). INTERVENTION(S): Patients started GnRH-a administration on stimulation day 6 (group 1) or when the leading follicle reached a mean diameter of 14 mm (group 2). MAIN OUTCOME MEASURE(S): Implantation and pregnancy rates; serum E(2) and LH levels during ovarian stimulation; days of stimulation and GnRH-a administration. RESULT(S): Days needed for ovarian stimulation were similar in both groups but there was a significant difference when comparing days of GnRH-a administration. Serum E(2) and LH followed similar curves in both groups. Implantation and pregnancy rates were 23.7% and 44.4 % in group 1 and 28.6% and 50.9 % in group 2 (P=not significant [NS]). CONCLUSION(S): The efficacy of the two starting protocols of the multiple dose GnRH-a evaluated in this study is similar; however, this remark can only be drawn for a selected group of patients.
RCT Entities:
OBJECTIVE: To compare the efficacy of two starting protocols of multiple dose GnRH antagonists (GnRH-a). DESIGN: Prospective randomized controlled study. SETTING: In vitro fertilization-embryo transfer program at the Instituto Valenciano de Infertilidad, Valencia, Spain. PATIENT(S): One hundred nine patients undergoing controlled ovarian hyperstimulation (COH) with recombinant gonadotropins and GnRH-a (0.25 mg/d). INTERVENTION(S): Patients started GnRH-a administration on stimulation day 6 (group 1) or when the leading follicle reached a mean diameter of 14 mm (group 2). MAIN OUTCOME MEASURE(S): Implantation and pregnancy rates; serum E(2) and LH levels during ovarian stimulation; days of stimulation and GnRH-a administration. RESULT(S): Days needed for ovarian stimulation were similar in both groups but there was a significant difference when comparing days of GnRH-a administration. Serum E(2) and LH followed similar curves in both groups. Implantation and pregnancy rates were 23.7% and 44.4 % in group 1 and 28.6% and 50.9 % in group 2 (P=not significant [NS]). CONCLUSION(S): The efficacy of the two starting protocols of the multiple dose GnRH-a evaluated in this study is similar; however, this remark can only be drawn for a selected group of patients.
Authors: Zaramasina L Clark; Meghan L Ruebel; Peter Z Schall; Kaitlin R Karl; James J Ireland; Keith E Latham Journal: Endocrinology Date: 2022-09-01 Impact factor: 5.051