Half-dose, long-acting gonadotropin-releasing hormone agonist (Diphereline) is comparable with daily injections of short-acting gonadotropin-releasing hormone agonist (Suprefact) in IVF/ICSI cycles

Abstract

IntroductionThe aim of the study was to compare the efficacy of half-dose, long-acting GnRH analogue (Diphereline) with Suprefact in IVF/ICSI (in vitro fertilization/intracytoplasmic sperm injection) cycles.Material and methodsIn this randomized clinical trial performed in Royan Institute, 126 infertile women who were first time candidates for IVF/ICSI were enrolled. Patients were randomly divided into two groups by using a random number table. In one group, 62 patients received a single half dose, 1.87 mg Diphereline, in mid-luteal phase. In the other group, 64 cases were treated with buserelin from the previous mid-luteal phase. P value less than 0.05 was considered significant.ResultsThe mean age of patients in the Diphereline and Suprefact groups was 27.9 ±3.6 and 29.6 ±3.5 years, respectively (p = 0.01). In the Diphereline group, the mean number of used gonadotropins was 25.6 ±12.1 ampoules, while in the second group it was 25.9 ±8.5 ampoules. Numbers of retrieved and MII oocytes were significantly higher in the Diphereline group (12.1 ±6.3 and 9.6 ±5.5) in comparison to the Suprefact group (9.4 ±6.4 and 7.2 ±5.1). Although the number of developed embryos in the Diphereline group was statistically higher than in the Suprefact group (6.1 ±3.9 vs. 4.7 ±3.4, p = 0.04) there was no significant difference in pregnancy rate (37.1%, 95% CI [26.16-49.54] vs. 37.5%, 95% CI [26.67-49.75]).ConclusionsA half-dose, long-acting GnRH agonist can be successfully used in ovarian stimulation and produces a higher number of MII oocytes and embryos. The pregnancy rates with this method are acceptable.

Self‐control study on reduced‐dose depot versus daily administration of gonadotrophin‐releasing hormone agonists for pituitary desensitization in in vitro fertilization cycles

“…This may be because deeper downregulation in the LA group resulted in better follicle synchronization. Our results agree with previous reports …”

Mild starting dosage ovarian stimulation combined with a modified prolonged GnRH-a protocol improved IVF/ICSI outcomes in normal ovarian responders

“…In recent years, it has been suggested that prolonged pituitary inhibition may result in a higher pregnancy rate. Although a prolonged program of GnRH-a 3–6 months prior to ovarian stimulation has been reported to provide excellent results in IVF/ICSI [3, 4], a few months of down-regulation before IVF-ET may be unacceptable. Reported studies and our experiences have shown that a new modified prolonged protocol, with down-regulation starting at the beginning of the menstrual cycle, may also improve the clinical outcomes of IVF/ICSI [5].…”

Experimental research Comparisons of the effects of long-acting and short-acting GnRH agonists on embryo quality, endometrial thickness and pregnancy rate in human in vitro fertilization

“…However, the effect of long-acting and short-acting GnRH agonists in IVF-ET by long protocol on endometrial thickness is still not known in detail. In addition, recent studies found that there was no significant difference in terms of clinical outcomes between long-acting and short-acting GnRH agonist protocols [ 14 , 15 ].…”