Human Reproduction, Vol. 15, No. 11, 2333-2340,
November 2000
© 2000 European Society of Human Reproduction and Embryology
Dose-finding study of triptorelin acetate for prevention of a premature LH surge in IVF: a prospective, randomized, double-blind, placebo-controlled study
Research Institute for Endocrinology, Reproduction and Metabolism, IVF Center, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
Gonadotrophin-releasing hormone agonists (GnRHa) are routinely used in IVF programmes to prevent an unwanted LH surge and consequent ovulation. Despite its widespread use in IVF, a convincing dose recommendation for GnRHa in IVF does not exist. In our opinion, the lowest possible dose of GnRHa should be used. Thus, we performed a prospective, randomized, double-blind, placebo-controlled study to determine the minimal daily dose of triptorelin acetate needed to suppress a premature LH surge during IVF treatment in a long protocol. A total of 240 women (60 in each group) was randomized to either placebo or to one of three doses of triptorelin, i.e. 15, 50 or 100 µg daily. Ovarian stimulation was performed with two or three ampoules of FSH daily. A premature LH surge occurred in 23% of placebo-treated patients, but in none of the triptorelin acetate-treated patients. There were significantly more oocytes and embryos in the 50 and 100 µg triptorelin groups. There was no dose relationship in rates of either implantation, pregnancy, ongoing pregnancy, live birth or baby take-home. In this study we showed that daily administration of 15 µg triptorelin is sufficient to prevent a premature LH surge, and that 50 µg is equivalent to 100 µg in terms of IVF results.
Key words: dose reduction/IVF/LH surge/triptorelin
1 To whom correspondence should be addressed at: Department of Obstetrics and Gynaecology, Free University Hospital, IVF Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: cb.lambalk{at}azvu.nl
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