PROSPECTIVE-STUDY OF A MODIFIED GONADATROPIN-RELEASING HORMONE AGONIST LONG PROTOCOL IN AN IN-VITRO FERTILIZATION PROGRAM

Objective: To determine if pituitary suppression is still maintained i f GnRH agonist (GnRH-a) is discontinued as gonadotropin stimulation is begun in a long protocol. Design: Prospective, randomized study. Sett ing: An outpatient IVF-GIFT program. Patients: One hundred seventy-thr ee patients entering an IVF-GIFT program. Interventions: Gonadotropin- releasing hormone agonist in long protocol was either discontinued or continued as gonadotropin stimulation was begun. Main Outcome Measures : Luteinizing hormone (LH), E(2), and P levels, egg numbers, fertiliza tion rate, number of embryos transferred, day of gonadotropin stimulat ion, and pregnancy rates (PRs). Results: Pituitary suppression was mai ntained although GnRH-a was discontinued as gonadotropin stimulation w as begun. No spontaneous LH surge was seen, and PRs were increased in the IVF patients. Conclusion: This study indicates that the advantages gained from use of GnRH-a in the long protocol are not compromised by its early discontinuation.