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Human Reproduction, Vol. 8, No. 12, pp. 2052-2055, 1993
© 1993 European Society of Human Reproduction and Embryology

review-article

Endocrinology: Subcutaneous goserelin versus intranasal buserelin for pituitary down-regulation in patients undergoing IVF: a randomized comparative study

Juha Tapanainen1, Outi Hovatta2, Kaisa Juntunen, Hannu Martikainen, Kari Ratsula2, Maija Tulppala2 and Leena Tuomivaara2

Department of Obstetrics and Gynaecology, University of Oulu FIN-90220 Oulu 2The Finnish Population and Family Welfare Federation Kalevankatu 16, FIN-00100 Helsinki, Finland

Correspondence: 1To whom correspondence should be addressed

One-hundred women undergoing ovarian stimulation with gonadotrophin-releasing hormone agonist (GnRH-a) and a human menopausal gonadotrophin (HMG) for in-vitro fertilization (IVF) participated in this randomized comparative study. The effectiveness of long-acting s.c. goserelin (Zoladex depot; 49 patients) and intranasally (i.n.) administrated buserelin acetate (Suprefact; 51 patients) for pituitary down-regulation was compared. Treatment with s.c. goserelin (3.6 mg) or i.n. buserelin acetate (200 µg; 6 times/day) was started on day 21–23 of the cycle. Stimulation with 150 IU of HMG/day was started after at least 11 days of GnRH-a treatment. There were no differences in the time required for follicular development nor in the clinical outcome between groups treated with either goserelin or buserelin. The number of oocytes recovered in the goserelin group was 6.7 ± 5.0 versus 6.3 ± 4.9 in the buserelin group. There were 11 pregnancies after the use of goserelin (22.4%) and 12 pregnancies in those given buserelin (24.0%). The number of HMG ampoules needed for follicular maturation was higher in the goserelin group (27.9 ± 7.8) than in the buserelin group (24.6 ± 7.8, P < 0.05). The patients given buserelin suffered significantly more from tiredness, depression, headache and abdominal pain than those receiving goserelin, whereas there were no differences between the groups in experiencing mental irritability, nausea and swelling. Subcutaneous goserelin depot injection offers a useful alternative for pituitary down-regulation in IVF stimulation.

Key words: intranasal buserelin/IVF/subcutaneous goserelin


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