Hum. Reprod. Advance Access published online on March 23, 2006
Human Reproduction, doi:10.1093/humrep/del072
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1 Department of Gynecology, Cliniques Universitaires St Luc, Université Catholique de Louvain, Brussels, Belgium
* To whom correspondence should be addressed. BACKGROUND: The aim of the study was to investigate whether intranasal (IN) administration of a GnRH agonist could provide luteal support in IVF/ICSI patients. METHODS: Controlled ovarian hyperstimulation (COH) was performed using hMG/FSH and a GnRH antagonist. Patients were then randomly allocated to either 10 000 IU hCG, followed by vaginal administration of micronized progesterone (3x 200 mg/day) (group A), or 200 µg IN buserelin followed by either 100 µg every 2 days (group B), or 100 µg every day (group C), or 100 µg twice a day (group D), or 100 µg three times a day (group E). Luteal support was continued for 15 days. RESULTS: Twenty-three patients were randomized. Groups B and C were discontinued prematurely in view of the short luteal phase. The luteal phase was significantly shorter in groups B, C and D, whereas group E was comparable with group A, 13.5 and 13.0 days, respectively. In the mid-luteal phase, median progesterone levels were significantly lower in groups B, C and D, whereas group E was comparable with group A, 68.9 and 98.0 ng/ml, respectively. Estradiol (E2) was significantly reduced in groups B and D but sustained in group E. In the hCG group, LH levels were undetectable (<0.1 IU/l), whereas LH was detectable and significantly higher in groups C, D and E. Two pregnancies were obtained in the hCG group (two of five), one ectopic and one ongoing. Three pregnancies were obtained in group E, one miscarriage and two ongoing twin pregnancies (three of five). CONCLUSION: IN administration of buserelin may be effective in triggering follicular maturation and providing luteal phase support in patients undergoing assisted reproduction techniques (ART).
Received November 17, 2005
Revised January 3, 2006
Accepted February 10, 2006
Article
GnRH agonist as luteal phase support in assisted reproduction technique cycles: results of a pilot study
C. Pirard 1,
J. Donnez 1 *,
and
E. Loumaye 1
J. Donnez, E-mail: donnez{at}gyne.ucl.ac.be
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