In vitro fertilization for women with pure tubal occlusion: the impact of short gonadotropin-releasing hormone agonist treatment

Abstract

Objective: To evaluate the impact of a short GnRH agonist (GnRH-a) protocol on follicular and luteal characteristics and treatment outcome in women undergoing IVF for isolated pure tubal occlusion.

Design: A prospective randomized study.

Patients: Eighty patients with pure tubal occlusion undergoing IVF for the first time.

Interventions: Patients in group 1 (control group) were administered hMG from day 3 of the menstrual cycle. Patients in group 2 were administered 900 micrograms/d buserelin acetate intranasally from day 1 of the menstrual cycle, followed by hMG administration from day 3. Buserelin acetate was discontinued on the day of hCG administration.

Main outcome measures: Information collected included E2 levels and follicular growth throughout cycle, amount of hMG required for stimulation, number of oocytes retrieved, fertilization, pregnancy, and cancellation rates.

Results: The short GnRH-a protocol resulted in significantly higher E2 levels and required less hMG for stimulation. However, the number of follicles aspirated, number of oocytes retrieved, fertilization rate, number of embryos transferred, pregnancy rate, and cancellation rate in both groups were comparable.

Conclusions: The findings suggest that administration of a short protocol of GnRH-a to patients with pure tubal occlusion has no obvious superiority in comparison with hMG alone, except for the lower amount of hMG required for ovarian stimulation.