Human Reproduction, Vol 13, 1148-1151, Copyright © 1998 by Oxford University Press
F Neuspiller, M Levy, J Remohi, A Ruiz, C Simon and A Pellicer
Evidence accumulated in in-vitro fertilization (IVF) cycles suggests that
the use of long-acting forms of gonadotrophin-releasing hormone analogues
(GnRHa) for pituitary desensitization may impair the outcome of IVF as
compared to classical short-acting formulations. Whether the negative
effects are directed against the corpus luteum, the endometrium, or both is
unknown. However, the presence of high affinity binding sites for
gonadotrophin-releasing hormone (GnRH) in the human endometrium suggests a
possible role of these analogues on this target organ, affecting embryo
implantation. In the present study, we tested direct effects of two
different forms of GnRHa on implantation using the ovum donation model.
Patients were prospectively allocated to one of the three study groups: the
short-acting form of the analogue leuprolide acetate (group I; n=64), the
long-acting form of the same analogue (group II; n=58), and the long-acting
preparation of the analogue tryptorelin (group III; n=61). A total of 68
cycles of embryo transfer was carried out in group I, whereas 67 were
performed in group II and 65 in group III. Cancellation rates were
respectively 18.1, 17.3 and 18.8% because of bleeding while being on the
waiting list for anonymous oocyte donation. The number of oocytes donated,
fertilization rates and embryos replaced in each group were similar. As a
result, pregnancy rate per transfer was 38.2, 49.3 and 44.6% respectively.
Implantation rates per embryo replaced were respectively 13.4, 19.1 and
17.0%. These data suggest that the use of a long-acting form of GnRHa
provides success rates similar to the short-acting preparations, resulting
in more convenient medication for patients with ovarian function included
in ovum donation programmes.
ARTICLES
The use of long- and short-acting forms of gonadotrophin-releasing hormone analogues in women undergoing oocyte donation
Instituto Valenciano de Infertilidad, Valencia University School of Medicine, Spain.
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