IN-VITRO FERTILIZATION FOR WOMEN WITH PURE TUBAL OCCLUSION - THE IMPACT OF SHORT GONADOTROPIN-RELEASING-HORMONE AGONIST TREATMENT

Objective: To evaluate the impact of a short GnRH agonist (GnRH-a) pro tocol on follicular and luteal characteristics and treatment outcome i n women undergoing IVF for isolated pure tubal occlusion. Design: A pr ospective randomized study. Patients: Eighty patients with pure tubal occlusion undergoing IVF for the first time. Interventions: Patients i n group I (control group) were administered hMG from day 3 of the mens trual cycle. Patients in group 2 were administered 900 mu g/d busereli n acetate intranasally from day 1 of the menstrual cycle, followed by hMG administration from day 3. Buserelin acetate was discontinued on t he day of hCG administration. Main Outcome Measures: Information colle cted included E(2) levels and follicular growth throughout cycle, amou nt of hMG required for stimulation, number of oocytes retrieved, ferti lization, pregnancy, and cancellation rates. Results: The short GnRH-a protocol resulted in significantly higher E(2) levels and required le ss hMG for stimulation. However, the number of follicles aspirated, nu mber of oocytes retrieved, fertilization rate, number of embryos trans ferred, pregnancy rate, and cancellation rate in both groups were comp arable.Conclusions: The findings suggest that administration of a shor t protocol of GnRH-a to patients with pure tubal occlusion has no obvi ous superiority in comparison with hMG alone, except for the lower amo unt of hMG required for ovarian stimulation.