PITUITARY DOWN-REGULATION PRIOR TO IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER - A COMPARISON BETWEEN A SINGLE-DOSE OF ZOLADEX DEPOT AND MULTIPLE DAILY DOSES OF SUPREFACT

In order to further evaluate the endocrinological, embryological and c linical efficacy of a single injection of the gonadotrophin-releasing hormone (GnRH) analogue Zoladex (goserelin), 142 women underwent pitui tary down-regulation prior to in-vitro fertilization and embryo transf er: 71 with a single injection of Zoladex depot (group I) and 71 match ed controls with multiple daily injections of Suprefact (buserelin; gr oup II), Ovarian stimulation was performed with human menopausal gonad otrophin (HMG) and ovulation induction with human chorionic gonadotrop hin (HCG), HMG and hydroxyprogesterone caproate depot were given for l uteal phase support, The mean (+/- SD) age (34.01 +/- 4.42 versus 34.8 1 +/- 4.00 Sears), mean total dosage of HMG (61.25 +/- 26.87 versus 56 .17 +/- 25.18 ampoules), mean daily dosage of HMG (4.74 versus 4.94 am poules), duration of HMG stimulation (12.91 +/- 3.68 versus 11.31 +/- 3.46 days) and oestradiol concentration on the day of HCG (10 082 +/- 8007 versus 9440 +/- 7840 pmol/l) were similar in both groups but the mean total number of injections (GnRH and HMG) (13.55 +/- 3.35 versus 55.37 +/- 31.92) was significantly lower in group I, Furthermore, the proportion of women downregulated by 2 weeks and pregnancy rate per em bryo transfer were significantly higher in the Zoladex group, while mi scarriage rates were similar, We conclude that a single dose of Zolade x is quicker, more convenient and should be investigated as an equally effective alternative to mutiple doses of Suprefact for pituitary dow n-regulation prior to assisted conception, Further studies are require d to test the teratogenicity and effectiveness of Zoladex.