Hum. Reprod. Advance Access originally published online on July 17, 2007
Human Reproduction 2007 22(9):2449-2454; doi:10.1093/humrep/dem223
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Clinical outcome with half-dose depot triptorelin is the same as reduced-dose daily buserelin in a long protocol of controlled ovarian stimulation for ICSI/embryo transfer: a randomized double-blind clinical trial (NCT00461916)
1 Department of Obstetrics and Gynecology, Dr. Shariati Hospital, Medical Sciences/University of Tehran, North Kargar Avenue, Tehran 14114, Iran 2 Department of Community and Preventive Medicine, Medical Sciences/University of Tehran, Poursina Street, Ghods Street, Enghelab Square, Tehran, Iran 3 Department of Anesthesiology and Critical Care Medicine, Medical Sciences/University of Tehran, Sina Hospital, Imam Khomeini Avenue, Tehran, Iran
4 Correspondence address. Tel: +98 912 38 38 464; Fax: +98 21 6671 6545; E-mail: medlars{at}gmail.com
BACKGROUND: Traditional doses of depot GnRH agonist may be excessive for ovarian stimulation. We compared half-dose depot triptorelin (Group I) with reduced-dose daily buserelin (Group II) in a long protocol ICSI/embryo transfer through a double-blind randomized clinical trial.
METHODS: Controlled ovarian stimulation (COS) was started by a pretreatment with oral contraceptives for 21 days. Then, 182 patients were randomized into two groups of 91. Group I received 1.87 mg triptorelin depot i.m. followed by daily s.c. injections of saline. Group II (reduced-dose protocol) received a bolus injection of i.m. saline followed by daily s.c. injections of 0.5 mg buserelin, which was then reduced to 0.25 mg at the start of human menopausal gonadotrophin stimulation. When transvaginal ultrasound showed at least two follicles of 16–20 mm diameter, HCG was given and ICSI was performed 40–42 h later.
RESULTS: No significant differences were seen in the mean (SD) number of follicles at HCG administration, as our primary outcome [10.3 (4.4) in Group I versus 11.1 (4.2) in Group II, P = 0.180, mean difference = 0.86, 95% confidence interval 0.39–2.11]. The other early results of COS, clinical and ongoing pregnancy rates, or early pregnancy loss were also not significantly different between the groups. Group I endured longer stimulation period [11.2 (1.8) days versus 10.6 (1.9), P = 0.030].
CONCULSIONS: Clinical outcomes were not significantly different between Group I and Group II.
Key words: depot triptorelin/daily buserelin/controlled ovarian stimulation/long protocol/ICSI
Submitted on April 22, 2007; resubmitted on June 7, 2007; accepted on June 21, 2007.