Half-dose depot triptorelin in pituitary suppression for multiple ovarian stimulation in assisted reproduction technology: A randomized study

Abstract

Background: Pituitary suppression by depot GnRH agonist may be excessive for ovarian stimulation in assisted reproduction technology. This study compares the efficacy of standard and half-dose depot triptorelin in a long protocol. Methods: A total of 180 patients were randomized into two groups using sealed envelopes. Pituitary desensitization was obtained in group 1 (90 patients) with half-dose (1.87mg) triptorelin depot in the mid-luteal phase of their menstrual cycle, and in group 2 (90 patients) with full-dose (3.75mg) triptorelin. Results: There was no premature LH surge, with LH levels being lower in the full-dose group (1.04 ± 0.05 versus 0.7 ± 0.06 IU/l on the day of hCG). The number of FSH ampoules used was lower in group 1 (42 ± 2 versus 59 ± 3). The numbers of mature oocytes (10.1 ± 0.54 versus 7.4 ± 0.55), of fertilized oocytes (8.24 ± 0.35 versus 6.34 ± 0.37) and of embryos (7.8 ± 0.36 versus 5.9 ± 0.37) were significantly higher in group 1. No significant differences were found in pregnancy (38.8 versus 25.3%), implantation (22.6 versus 13.8%) or abortion (6.1 versus 5.0%) rates. Cumulative pregnancy (fresh plus frozen embryo transfers: 56.8 versus 35.4%) rate was significantly higher in group 1. Conclusion: A half-dose of depot triptorelin can be successfully used in ovarian stimulation for IVF and produce a higher number of good quality embryos with a good chance of implantation. © European Society of Human Reproduction and Embryology 2004; all rights reserved.