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Hum. Reprod. Advance Access published online on December 17, 2004
Human Reproduction, doi:10.1093/humrep/deh685
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Human Reproduction © European Society of Human Reproduction and Embryology 2004; all rights reserved
Received September 20, 2004
Accepted November 25, 2004

Article

Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study

M.J. Pelinck 1, N.E.A. Vogel 1, A. Hoek 1, E.G.J.M. Arts 1, A.H.M. Simons 1, and M.J. Heineman 1*

1 Section of Reproductive Medicine, Department of Obstetrics and Gynaecology, University Hospital Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands

* To whom correspondence should be addressed.
M.J. Heineman, E-mail: m.j.heineman{at}og.azg.nl


  Abstract

BACKGROUND: The use of the natural cycle for IVF offers the advantage of a patient-friendly and low-risk protocol. Its effectiveness is limited, but may be improved by using a GnRH antagonist to prevent untimely LH surges. METHODS: In this pilot study, minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and simultaneous substitution with recombinant FSH was applied for a maximum of three cycles per patient. Main outcome measures were pregnancy rates per started cycle and cumulative pregnancy rates after three cycles. RESULTS: A total of 50 patients completed 119 cycles (2.4 per patient). Fifty-two embryo transfers resulted in 17 ongoing pregnancies [14.3% per started cycle; 32.7% per embryo transfer; 95% confidence interval (CI) 7.9-20.7% and 19.7-45.7%, respectively]. One dizygotic twin pregnancy occurred after transfer of two embryos, the other pregnancies were singletons. The cumulative ongoing pregnancy rate after three cycles was 34% (95% CI 20.6-47.4%). Live birth rate was 32% per patient (95% CI 18.8-45.2%). CONCLUSIONS: Pregnancy rates after IVF with minimal, late follicular phase stimulation are encouraging. Considering the low-risk and patient-friendly nature of this protocol, it may be a feasible alternative to IVF with ovarian hyperstimulation.

Keywords: GnRH antagonist; IVF; minimal stimulation; natural cycle/single embryo transfer.
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M.J. Pelinck, N.E.A. Vogel, E.G.J.M. Arts, A.H.M. Simons, M.J. Heineman, and A. Hoek
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