INTRANASAL NAFARELIN VERSUS BUSERELIN (SHORT PROTOCOL) FOR CONTROLLEDOVARIAN HYPERSTIMULATION BEFORE IN-VITRO FERTILIZATION - A PROSPECTIVE CLINICAL-TRIAL

The aim of this study was to compare the effect of nafarelin acetate w ith that of buserelin acetate nasal spray, when administered in a 'sho rt' protocol, as an adjunct to human menopausal gonadotropin (hMG) for controlled ovarian hyperstimulation before in vitro fertilization (IV F). Twenty-two IVF subjects were randomly recruited. Each underwent tw o consecutive treatment cycles; one with buserelin (900 mu g/day) and another with nafarelin (400 mu g/day). The treatment protocol included transnasal gonadotropin-releasing hormone (GnRH) analog from the seco nd cycle day and hMG from the fourth day of the cycle. The buserelin a nd nafarelin cycles did not differ significantly in the following para meters: baseline hormone profile, duration of GnRH analog treatment, m ean hMG dose required, peak estradiol levels, number of preovulatory f ollicles, number of aspirated oocytes, fertilization rate and number o f transferred or frozen embryos. No side-effects or cancellations of t reatment were recorded. The average dose required was lower for nafare lin and, because this analog was given only twice a day, it was more c onvenient to administer. These findings suggest that nafarelin is as e ffective as buserelin (when administered in a 'short' protocol) in ach ieving controlled ovarian hyperstimulation. It even offers advantages over buserelin with respect to the total dose required (which probably reflects its relatively high potency) and the subjects' compliance.