Prospective study of a modified gonadotropin-releasing hormone agonist long protocol in an in vitro fertilization program

Abstract

Objective: To determine if pituitary suppression is still maintained if GnRH agonist (GnRH-a) is discontinued as gonadotropin stimulation is begun in a long protocol.

Design: Prospective, randomized study.

Setting: An outpatient IVF-GIFT program.

Patients: One hundred seventy-three patients entering an IVF-GIFT program.

Interventions: Gonadotropin-releasing hormone agonist in long protocol was either discontinued or continued as gonadotropin stimulation was begun.

Main outcome measures: Luteinizing hormone (LH), E2, and P levels, egg numbers, fertilization rate, number of embryos transferred, day of gonadotropin stimulation, and pregnancy rates (PRs).

Results: Pituitary suppression was maintained although GnRH-a was discontinued as gonadotropin stimulation was begun. No spontaneous LH surge was seen, and PRs were increased in the IVF patients.

Conclusion: This study indicates that the advantages gained from use of GnRH-a in the long protocol are not compromised by its early discontinuation.