A NOVEL METHOD OF OVARIAN STIMULATION FOR IN-VITRO FERTILIZATION - BROMOCRIPTINE-REBOUND METHOD

Objective: To examine whether a new method of ovarian stimulation, bro mocriptine-rebound method, improves IVF outcomes compared with the con ventional long protocol of GnRH agonist and hMG regimen. Design: A pro spective clinical trial. Setting: In vitro fertilization program at a university hospital. Patients: Endocrine-normal ovulatory women less t han 40 years of age, with normal male partners and previous failed IVF -ET using long protocol. Interventions: Patients were assigned to eith er bromocriptine-rebound method (group 1) or long protocol (group 2). The bromocriptine-rebound method was the same as the long protocol, ex cept that bromocriptine was administered daily from day 4 of the prece ding cycle until 7 days before hMG stimulation. Main Outcome Measures: The number of cleaved and morphologically superior embryos, pregnancy rate per oocyte pick-up, and serum PRL concentrations during administ rations of hMG. Results: Significantly more embryos were cleaved and h ad superior morphology in group 1 than group 2. Clinical and ongoing p regnancy rates per oocyte pick-up were significantly higher in group 1 (42% and 38%, respectively) than group 2 (24% and 21%, respectively). The mean PRL concentration was significantly higher in the group 1 th an group 2. A significant correlation between the number of superior e mbryos and PRL concentrations was observed in group 1, but not in grou p 2. Conclusion: The bromocriptine-rebound method enhanced embryonic d evelopment, resulting in an increased pregnancy rate compared with the long protocol.