Efficacy of nafarelin in assisted reproductive technology: a meta-analysis

A systematic review identified nine randomized, controlled trials (both pub lished and unpublished) which assessed the efficacy of nafarelin during IVF compared with other gonadotrophin-releasing hormone (GnRH) agonists, The t rials included 1014 women (nafarelin n = 597) in protocols employing three different dosage regimens, long and short stimulation protocols, and three comparative GnRH agonists (buserelin n = 348; triptorelin n = 14, and leupr olide n = 55), The meta-analysis of the data showed that pregnancy rates pe r embryo transfer with nafarelin were equivalent to those obtained with oth er GnRH agonists, Nafarelin and other agonists were also comparable in term s of several intermediate NF outcomes, including fertilization rates, numbe r of oocytes retrieved, peak oestradiol concentrations, and cycle cancellat ions, Women treated with nafarelin required fewer ampoules of human menopau sal gonadotrophin (HMG)/FSH for ovarian stimulation and fewer days of stimu lation. Safety results from both the meta-analysis and a qualitative analys is of 12 additional reports suggested that adverse effects were within the accepted tolerance range; the most frequent adverse effects were hypo-oestr ogenic symptoms, In conclusion, the overall efficacy of nafarelin was equiv alent to that of other GnRH agonists, The possibility that the reduced gona dotrophin requirements in women taking nafarelin will translate into cost s avings per IVF treatment cycle requires further study.