Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jun 27;18(3):76-79.
doi: 10.5935/1518-0557.20140011.

Pituitary suppression with a GnRHa short protocol in an alternate day schedule associated with rhCG microdoses

Rosane S Rodrigues  1 , Amanda S Setti  1   2 , Daniela P A F Braga  1   2 , Fernanda M Valente  1 , Assumpto Iaconelli Jr  1   2 , Edson Borges Jr  1   2
Affiliations

Pituitary suppression with a GnRHa short protocol in an alternate day schedule associated with rhCG microdoses

Rosane S Rodrigues et al. JBRA Assist Reprod. .

Abstract

Objective: To evaluate a comfortable short protocol with GnRH agonist (GnRHa) in alternate days, with a step down method of gonadotropins administration associated with hCG microdose for young patients undergoing intracytoplasmic sperm injection.

Methods: This study evaluated 89 ICSI cycles performed in female patients aged <36 years. Patients were submitted to a short protocol with GnRHa schedule in the study group (n= 25) and to a long pituitary suppression protocol in the control group (n=64).

Results: The total dose of rFSH administered as well as estradiol levels on the day of hCG trigger were significantly lower in the short protocol group. There were no significant differences between the groups regarding the fertilization, high-quality embryos, implantation, pregnancy and miscarriage rates. However, mean ovarian stimulation cost (GnRHa short group: $2,397 ± $870.3 and control group: $3,197 ± $658.9, P <0.001) and mean ovarian stimulation cost per pregnancy (GnRHa short group: ($4,993 ± $1,813 and control group: $9,743 ± $2,008, P <0.001) were significantly lower in the GnRHa short group as compared to the control group.

Conclusion: In patients with normal ovarian response, pituitary suppression with a GnRHa short protocol in alternate days is less costly, requires lower gonadotropins doses and results in similar implantation and pregnancy rates as compared to a GnRHa long protocol.

Keywords: Conservative management; ovarian torsion; uneventful pregnancy.

PubMed Disclaimer

References

    1. Acharya U, Small J, Randall J, Hamilton M, Templeton A. Prospective study of short and long regimens of gonadotropin-releasing hormone agonist in in vitro fertilization program. Fertil Steril. 1992;57:815–818. - PubMed
    1. Braga DP, Setti AS, de Cassia SFR, Machado RB, Iaconelli A Jr., Borges E Jr. Patient selection criteria for blastocyst transfers in extended embryo culture programs. J Assist Reprod Genet. 2012;29:1357–1362. - PMC - PubMed
    1. Cavagna M, Maldonado LG, de Souza Bonetti TC, de Almeida Ferreira Braga DP, Iaconelli A Jr., Borges E Jr. Supplementation with a recombinant human chorionic gonadotropin microdose leads to similar outcomes in ovarian stimulation with recombinant follicle-stimulating hormone using either a gonadotropin-releasing hormone agonist or antagonist for pituitary suppression. Fertil Steril. 2010;94:167–172. - PubMed
    1. Fabregues F, Penarrubia J, Creus M, Casamitjana R, Vanrell JA, Balasch J. Effect of halving the daily dose of triptorelin at the start of ovarian stimulation on hormone serum levels and the outcome of in vitro fertilization. Fertil Steril. 2005;83:785–788. - PubMed
    1. Filicori M, Cognigni GE, Gamberini E, Parmegiani L, Troilo E, Roset B. Efficacy of low-dose human chorionic gonadotropin alone to complete controlled ovarian stimulation. Fertil Steril. 2005;84:394–401. - PubMed