Dose-finding study of triptorelin acetate for prevention of a premature LHsurge in IVF: a prospective, randomized, double-blind, placebo-controlled study

Gonadotrophin-releasing hormone agonists (GnRHa) are routinely used in IVF programmes to prevent an unwanted LH surge and consequent ovulation, Despit e its widespread use in IVF, a convincing dose recommendation for GnRHa in IVF does not exist. In our opinion, the lowest possible dose of GnRHa shoul d be used. Thus, me performed a prospective, randomized, double-blind, plac ebo-controlled study to determine the minimal daily dose of triptorelin ace tate needed to suppress a premature LH surge during IVF treatment in a long protocol. A total of 240 women (60 in each group) was randomized to either placebo or to one of three doses of triptorelin, i.e. 15, 50 or 100 mug da ily. Ovarian stimulation was performed with two or three ampoules of FSH da ily. A premature LH surge occurred in 23% of placebo-treated patients, but in none of the triptorelin acetate-treated patients. There were significant ly more oocytes and embryos in the 50 and 100 mug triptorelin groups, There was no dose relationship in rates of either implantation, pregnancy, ongoi ng pregnancy, live birth or baby take-home. In this study we showed that da ily administration of 15 mug triptorelin is sufficient to prevent a prematu re LH surge, and that 50 mug is equivalent to 100 mug in terms of IVF resul ts.