COMPARISON BETWEEN DEPOT AND STANDARD RELEASE TRIPTORELINE IN IN-VITRO FERTILIZATION - PITUITARY SENSITIVITY, LUTEAL FUNCTION, PREGNANCY OUTCOME, AND PERINATAL RESULTS

Objective: To compare the effects of depot and standard release form o f triptoreline in superovulation induction in IVF programs. Design: On e hundred ninety-six patients undergoing IVF were randomized between t wo treatment groups. Pituitary desensitization was obtained in group 1 (102 patients) with a single IM injection of 3.75 mg D-Trp-6-luteiniz ing hormone-releasing hormone (LH-RH) and, in group 2 (94 patients), w ith daily SC administration of 0.1 mg D-Trp-6-LH-RH. In a subgroup of 11 patients, a series of GnRH tests was performed to investigate pitui tary desensitization and, in another subgroup of 12 patients, a study of luteal phase steroid profile was performed. In an additional 23 pat ients, a series of GnRH tests were performed to investigate pituitary desensitization during the late follicular and midluteal phases. Resul ts: No differences were found in the time necessary to reach desensiti zation (11.3 +/- 1.03 versus 11.3 +/- 1.45 days; mean +/- SEM), wherea s resumption of pituitary activity takes place in 7 days after the dis continuation of the daily form and in about 2 months after discontinua tion of the depot form. No differences were found in the duration of s timulation, number of FSH ampules, E, levels, and number of follicles (11.7 +/- 0.68. versus 12.2 +/- 0.68) on hCG administration day and th e total oocytes collected (9.1 +/- 0.6 versus 9.2 +/- 0.64). Oocyte qu ality, percentage of fertilization and cleavage, pregnancy rate per tr ansfer (28.7% versus 25.6%), and miscarriages (about 30%) were similar in the two protocols. No difference was found in hormonal levels duri ng the luteal phase. In both groups there was a high incidence of mult iple pregnancy. Conclusion: Comparable results can be achieved with bo th long-acting and standard-release forms of GnRH analogs in patients undergoing assisted reproduction in terms of follicular stimulation an d abortion rates despite differences in the duration of pituitary supp ression.