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GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study.
Hum Reprod. 2005 May; 20(5):1213-20.HR

Abstract

BACKGROUND

We aimed to determine the efficacy of ovarian hyperstimulation protocols employing a GnRH antagonist to prevent a premature LH rise allowing final oocyte maturation and ovulation to be induced by a single bolus of either a GnRH agonist or hCG.

METHODS

A total of 122 normogonadotrophic patients following a flexible antagonist protocol was stimulated with recombinant human FSH and prospectively randomized (sealed envelopes) to ovulation induction with a single bolus of either 0.5 mg buserelin s.c. (n = 55) or 10,000 IU of hCG (n = 67). A maximum of two embryos was transferred. Luteal support consisted of micronized progesterone vaginally, 90 mg a day, and estradiol, 4 mg a day per os.

RESULTS

Ovulation was induced with GnRH agonist in 55 patients and hCG in 67 patients. Significantly more metaphase II (MII) oocytes were retrieved in the GnRH agonist group (P < 0.02). Significantly higher levels of LH and FSH (P < 0.001) and significantly lower levels of progesterone and estradiol (P < 0.001) were seen in the GnRH agonist group during the luteal phase. The implantation rate, 33/97 versus 3/89 (P < 0.001), clinical pregnancy rate, 36 versus 6% (P = 0.002), and rate of early pregnancy loss, 4% versus 79% (P = 0.005), were significantly in favour of hCG.

CONCLUSIONS

Ovulation induction with a GnRH agonist resulted in significantly more MII oocytes. However, a significantly lower implantation rate and clinical pregnancy rate in addition to a significantly higher rate of early pregnancy loss was seen in the GnRH agonist group, most probably due to a luteal phase deficiency.

Authors+Show Affiliations

The Fertility Clinic, Viborg Hospital (Skive), Denmark. peter.humaidan@sygehuviborg.dkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15760966

Citation

Humaidan, P, et al. "GnRH Agonist (buserelin) or hCG for Ovulation Induction in GnRH Antagonist IVF/ICSI Cycles: a Prospective Randomized Study." Human Reproduction (Oxford, England), vol. 20, no. 5, 2005, pp. 1213-20.
Humaidan P, Bredkjaer HE, Bungum L, et al. GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. Hum Reprod. 2005;20(5):1213-20.
Humaidan, P., Bredkjaer, H. E., Bungum, L., Bungum, M., Grøndahl, M. L., Westergaard, L., & Andersen, C. Y. (2005). GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. Human Reproduction (Oxford, England), 20(5), 1213-20.
Humaidan P, et al. GnRH Agonist (buserelin) or hCG for Ovulation Induction in GnRH Antagonist IVF/ICSI Cycles: a Prospective Randomized Study. Hum Reprod. 2005;20(5):1213-20. PubMed PMID: 15760966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: a prospective randomized study. AU - Humaidan,P, AU - Bredkjaer,H Ejdrup, AU - Bungum,L, AU - Bungum,M, AU - Grøndahl,M L, AU - Westergaard,L, AU - Andersen,C Yding, Y1 - 2005/03/10/ PY - 2005/3/12/pubmed PY - 2005/9/1/medline PY - 2005/3/12/entrez SP - 1213 EP - 20 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 20 IS - 5 N2 - BACKGROUND: We aimed to determine the efficacy of ovarian hyperstimulation protocols employing a GnRH antagonist to prevent a premature LH rise allowing final oocyte maturation and ovulation to be induced by a single bolus of either a GnRH agonist or hCG. METHODS: A total of 122 normogonadotrophic patients following a flexible antagonist protocol was stimulated with recombinant human FSH and prospectively randomized (sealed envelopes) to ovulation induction with a single bolus of either 0.5 mg buserelin s.c. (n = 55) or 10,000 IU of hCG (n = 67). A maximum of two embryos was transferred. Luteal support consisted of micronized progesterone vaginally, 90 mg a day, and estradiol, 4 mg a day per os. RESULTS: Ovulation was induced with GnRH agonist in 55 patients and hCG in 67 patients. Significantly more metaphase II (MII) oocytes were retrieved in the GnRH agonist group (P < 0.02). Significantly higher levels of LH and FSH (P < 0.001) and significantly lower levels of progesterone and estradiol (P < 0.001) were seen in the GnRH agonist group during the luteal phase. The implantation rate, 33/97 versus 3/89 (P < 0.001), clinical pregnancy rate, 36 versus 6% (P = 0.002), and rate of early pregnancy loss, 4% versus 79% (P = 0.005), were significantly in favour of hCG. CONCLUSIONS: Ovulation induction with a GnRH agonist resulted in significantly more MII oocytes. However, a significantly lower implantation rate and clinical pregnancy rate in addition to a significantly higher rate of early pregnancy loss was seen in the GnRH agonist group, most probably due to a luteal phase deficiency. SN - 0268-1161 UR - https://www.unboundmedicine.com/medline/citation/15760966/GnRH_agonist__buserelin__or_hCG_for_ovulation_induction_in_GnRH_antagonist_IVF/ICSI_cycles:_a_prospective_randomized_study_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/deh765 DB - PRIME DP - Unbound Medicine ER -