Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization

Mark P. Leondires, Mariabelle Escalpes, James Segars, Richard T. Scott, Bradley T. Miller

Research output: Contribution to journalArticle

Abstract

Objective: To compare an ovarian stimulation protocol using microdose follicular phase GnRH agonist (GnRH-a) and oral contraceptive (OC) pills to a luteal phase GnRH-a protocol. Design: Retrospective analysis. Setting: University affiliated IVF program. Patient(s): One hundred seventy patients who underwent IVF and ET in 1996. Intervention(s): Patients were assigned to either a midluteal start of leuprolide acetate (LA) 1 mg/d, reduced to 0.5 mg/d after addition of gonadotropins (LUT), or OC pills until cycle day 0 followed by 20 μg of LA every 12 hours on cycle day 3 with addition of gonadotropins on cycle day 5 (MICRO). Main Outcome Measure(s): Number of FSH ampules, days of stimulation, peak E2, and number of oocytes retrieved. Result(s): There were no statistically significant differences in the main outcome measures between the two groups using an age-matched ANOVA. Clinical pregnancy rate per cycle start was not statistically different (LUT = 54%, and MICRO = 37%). The cancellation rate was significantly higher in the MICRO group (22.5% vs. 8.2%). Conclusion(s): Given the higher cancellation rate in the microdose group, a randomized clinical trial is required to determine the possible benefit of a lower dose of GnRH-a in patients with normal ovarian function.

Original languageEnglish (US)
Pages (from-to)1018-1023
Number of pages6
JournalFertility and Sterility
Volume72
Issue number6
DOIs
StatePublished - Dec 1999
Externally publishedYes

Fingerprint

Follicular Phase
Ovulation Induction
Luteal Phase
Fertilization in Vitro
Gonadotropin-Releasing Hormone
Leuprolide
Oral Contraceptives
Gonadotropins
Outcome Assessment (Health Care)
Pregnancy Rate
Oocytes
Analysis of Variance
Randomized Controlled Trials
Age Groups

Keywords

  • Cost efficiency
  • In vitro fertilization
  • Microdose GnRH-a

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization. / Leondires, Mark P.; Escalpes, Mariabelle; Segars, James; Scott, Richard T.; Miller, Bradley T.

In: Fertility and Sterility, Vol. 72, No. 6, 12.1999, p. 1018-1023.

Research output: Contribution to journalArticle

@article{a61e9c57091247009bccd12e0165bf26,
title = "Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization",
abstract = "Objective: To compare an ovarian stimulation protocol using microdose follicular phase GnRH agonist (GnRH-a) and oral contraceptive (OC) pills to a luteal phase GnRH-a protocol. Design: Retrospective analysis. Setting: University affiliated IVF program. Patient(s): One hundred seventy patients who underwent IVF and ET in 1996. Intervention(s): Patients were assigned to either a midluteal start of leuprolide acetate (LA) 1 mg/d, reduced to 0.5 mg/d after addition of gonadotropins (LUT), or OC pills until cycle day 0 followed by 20 μg of LA every 12 hours on cycle day 3 with addition of gonadotropins on cycle day 5 (MICRO). Main Outcome Measure(s): Number of FSH ampules, days of stimulation, peak E2, and number of oocytes retrieved. Result(s): There were no statistically significant differences in the main outcome measures between the two groups using an age-matched ANOVA. Clinical pregnancy rate per cycle start was not statistically different (LUT = 54{\%}, and MICRO = 37{\%}). The cancellation rate was significantly higher in the MICRO group (22.5{\%} vs. 8.2{\%}). Conclusion(s): Given the higher cancellation rate in the microdose group, a randomized clinical trial is required to determine the possible benefit of a lower dose of GnRH-a in patients with normal ovarian function.",
keywords = "Cost efficiency, In vitro fertilization, Microdose GnRH-a",
author = "Leondires, {Mark P.} and Mariabelle Escalpes and James Segars and Scott, {Richard T.} and Miller, {Bradley T.}",
year = "1999",
month = "12",
doi = "10.1016/S0015-0282(99)00423-9",
language = "English (US)",
volume = "72",
pages = "1018--1023",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Microdose follicular phase gonadotropin-releasing hormone agonists (GnRH-a) compared with luteal phase GnRH-a for ovarian stimulation at in vitro fertilization

AU - Leondires, Mark P.

AU - Escalpes, Mariabelle

AU - Segars, James

AU - Scott, Richard T.

AU - Miller, Bradley T.

PY - 1999/12

Y1 - 1999/12

N2 - Objective: To compare an ovarian stimulation protocol using microdose follicular phase GnRH agonist (GnRH-a) and oral contraceptive (OC) pills to a luteal phase GnRH-a protocol. Design: Retrospective analysis. Setting: University affiliated IVF program. Patient(s): One hundred seventy patients who underwent IVF and ET in 1996. Intervention(s): Patients were assigned to either a midluteal start of leuprolide acetate (LA) 1 mg/d, reduced to 0.5 mg/d after addition of gonadotropins (LUT), or OC pills until cycle day 0 followed by 20 μg of LA every 12 hours on cycle day 3 with addition of gonadotropins on cycle day 5 (MICRO). Main Outcome Measure(s): Number of FSH ampules, days of stimulation, peak E2, and number of oocytes retrieved. Result(s): There were no statistically significant differences in the main outcome measures between the two groups using an age-matched ANOVA. Clinical pregnancy rate per cycle start was not statistically different (LUT = 54%, and MICRO = 37%). The cancellation rate was significantly higher in the MICRO group (22.5% vs. 8.2%). Conclusion(s): Given the higher cancellation rate in the microdose group, a randomized clinical trial is required to determine the possible benefit of a lower dose of GnRH-a in patients with normal ovarian function.

AB - Objective: To compare an ovarian stimulation protocol using microdose follicular phase GnRH agonist (GnRH-a) and oral contraceptive (OC) pills to a luteal phase GnRH-a protocol. Design: Retrospective analysis. Setting: University affiliated IVF program. Patient(s): One hundred seventy patients who underwent IVF and ET in 1996. Intervention(s): Patients were assigned to either a midluteal start of leuprolide acetate (LA) 1 mg/d, reduced to 0.5 mg/d after addition of gonadotropins (LUT), or OC pills until cycle day 0 followed by 20 μg of LA every 12 hours on cycle day 3 with addition of gonadotropins on cycle day 5 (MICRO). Main Outcome Measure(s): Number of FSH ampules, days of stimulation, peak E2, and number of oocytes retrieved. Result(s): There were no statistically significant differences in the main outcome measures between the two groups using an age-matched ANOVA. Clinical pregnancy rate per cycle start was not statistically different (LUT = 54%, and MICRO = 37%). The cancellation rate was significantly higher in the MICRO group (22.5% vs. 8.2%). Conclusion(s): Given the higher cancellation rate in the microdose group, a randomized clinical trial is required to determine the possible benefit of a lower dose of GnRH-a in patients with normal ovarian function.

KW - Cost efficiency

KW - In vitro fertilization

KW - Microdose GnRH-a

UR - http://www.scopus.com/inward/record.url?scp=0032753960&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032753960&partnerID=8YFLogxK

U2 - 10.1016/S0015-0282(99)00423-9

DO - 10.1016/S0015-0282(99)00423-9

M3 - Article

C2 - 10593374

AN - SCOPUS:0032753960

VL - 72

SP - 1018

EP - 1023

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 6

ER -