Cessation of gonadotropin-releasing hormone agonist therapy combined with high-dose gonadotropin stimulation yields favorable pregnancy results in low responders

Barbara M. Faber, Jake Mayer, Beverly Cox, Debi Jones, James P. Toner, Sergio Oehninger, Suheil J. Muasher

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the pregnancy results of an ovarian hyperstimulation protocol for IVF-ET that combines GnRH agonist down- regulation, cessation of GnRH agonist therapy with the onset of menstruation, and high-dose gonadotropin administration in low responders. Design: Prospective analysis. Setting: Academic IVF program. Patient(s): One hundred eighty-two low responders undergoing 224 IVF-ET cycles. Intervention(s): Down-regulation was obtained with the administration of leuprolide acetate beginning in the midluteal phase and ending with the onset of menses. Dally administration of 6 ampules of FSH alone or in combination with hMG was initiated on cycle day 3. Main Outcome Measure(s): Stimulation characteristics and pregnancy rates (PRs) were compared between fresh cycles in which pure FSH alone was used and 35 cycles in which a combination of FSH and hMG was administered. Result(s): The clinical PR per transfer, the ongoing PR per transfer, and the implantation rate were 32%, 24%, and 9%, respectively. No differences were noted between cycles in which pure FSH alone was used in comparison with cycles in which a combination of FSH and hMG was administered. Conclusion(s): Short-term ovarian suppression begun in the luteal phase and discontinued with the onset of menses followed by high- dose stimulation with gonadotropins yields favorable pregnancy results in low responders.

Original languageEnglish (US)
Pages (from-to)826-830
Number of pages5
JournalFertility and sterility
Volume69
Issue number5
DOIs
StatePublished - May 1998

Keywords

  • Cessation of GnRH agonist therapy
  • In vitro fertilization
  • Low responders

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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