Concomitant midcyclic GnRH antagonist treatment (Ganirelix) at different dosages

Methods: 23 patients were enrolled in this prospective randomited double-bl ind study. They were treated from cycle day 2 onward with recombinant FSH a nd from day 7 of the menstrual cycle onward with concomitant midcyclic admi nistration of the GnRH antagonist ganirelix (Organon, Oss, The Netherlands) at six different dosages (0.0625 mg, 0.125 mg, 0.25 mg, 0.5 mg, 1 mg and 2 mg) for IVF or IVF/ICSI. The hormone profiles of all patients could be inc luded. The profiles of LH, FSH, estradiol and progesterone according to the six different dosages, the consumption of gonadotropin, the number of retr ieved oocytes and embryos and their quality were compared. Results: Two premature LH surges (LH > 1OIU/ml) could be observed in the 0. 125 mg dosage group. The profile of estradiol showed a flatter course and l ess maximum values with increasing dosages of the GnRH antagonist. The valu es of estradiol at the time of ovulation-induction with HCG were significan tly lower in the high dosage group (2, 1, 0.5 mg) than in the low-dosage gr oup (0.0625, 0.125, 0.25 mg). However, the quality of the oocytes and embry os did not differ significantly and the pregnancy rate per follicular punct ure was 27.3 %. Conclusions: The combination of recombinant FSH and midcyclic administered GnRH antagonist is an effective and safe protocol for controlled ovarian hy perstimulation.