A COMPARISON BETWEEN A STANDARD AND REDUCED DOSE OF D-TRP-6-LUTEINIZING HORMONE-RELEASING HORMONE ADMINISTERED AFTER PITUITARY SUPPRESSION FOR IN-VITRO FERTILIZATION

A randomized prospective study was undertaken to compare low and stand ard luteinizing hormone-releasing hormone agonist (LHRHa) dosage used in combination with gonadotrophins in ovarian stimulation for in-vitro fertilization (IVF). A total of 42 ovulatory patients with mechanical infertility were administered 0.5 mg/day LHRHa (Decapeptyl) from day 21 of their cycles for 14 days. Following downregulation, patients wer e randomly allocated to continue with the same dose of LHRHa (22 patie nts, group A) or to receive a lower dose of 0.1 mg/day LHRHa (20 patie nts, group B) during folliculogenesis. Luteal phase was supported by d aily i.m. progesterone (50 mg) injections and human chorionic gonadotr ophin (HCG; 1500 IU) every 4 days. Ovarian response, human menopausal gonadotrophin (HMG) dosage used for induction of ovulation, evidence o f premature luteinization, and clinical and laboratory IVF outcome, we re compared between groups A and B. The two groups were comparable in respect of: age (32.6 +/- 0.7 and 33.0 +/- 0.9 years), HMG dosage (33. 0 +/- 1.6 and 36.0 +/- 2.5 ampoules), day of HCG (11.2 +/- 0.3 and 12. 2 +/- 0.4), oocytes/patient (13.3 +/- 1.0 and 12.9 +/- 1.3), fertiliza tion rate (68.5 and 65.2%), cleavage rate (95% for both), pregnancy/em bryo transfer (32 and 35%) and implantation rate (10.8 and 10.5%), for groups A and B respectively. There was no evidence of premature lutei nization or luteolysis in either group. It was concluded that lowering the dose of LHRHa to 0.1 mg/day during folliculogenesis had no advers e effect on ovarian response or clinical results. However, it had no a dvantage in reducing the HMG dose used for ovulation induction.