RESUMO
OBJECTIVE: To compare stimulation requirements and ICSI outcome when agonist treatment is started in the early follicular phase or in mid luteal phase of the cycle. METHODS: 181 infertile patients were randomly assigned to: group A (N=66) and group B (N=115). GnRH-a (Triptorelin) subcutaneous daily injections started on day 20-22 of the previous cycle till pituitary suppression is achieved where gonadotropins stimulation commenced. In group A, agonist treatment was started on the first or second days of the cycle, in group B it was started on day 20-22 of the cycle. The agonist treatment was continued till the day of (hCG) administration. RESULTS: The stimulation requirements were similar in the two groups. The days of t agonist treatment required to reach pituitary suppression were higher in group A: 12.5±6.4 than in group B, 11±4.5. Days of stimulation (10.4±1.7 and 10.3±1.6) and number of gonadotropin vials (40.1±8.7and 39.3±9.5) did not differ between both groups. The mean number of oocytes retrieved, mean number of embryos produced (11.7±7.4 and 13.3±9.3) (5.9±4.2and 6±5.2) were similar in both groups. The rates of fertilization and cleavage were similar in the two groups. Pregnancy rates were similar in both groups. The clinical pregnancy rates per cycle was 31.8% and 33%, while pregnancy rates per embryo transfer was 36.2 % and 36.5% in groups A and B respectively. CONCLUSION: Starting pituitary suppression with GnRH agonist in the early follicular phase or mid luteal phase were comparable regarding stimulation requirements and final outcomes.
Assuntos
Fármacos para a Fertilidade Feminina/administração & dosagem , Fármacos para a Fertilidade Feminina/uso terapêutico , Hormônio Liberador de Gonadotropina/agonistas , Gravidez/estatística & dados numéricos , Técnicas de Reprodução Assistida/estatística & dados numéricos , Adulto , Feminino , Humanos , Fase Luteal , Recuperação de Oócitos/estatística & dados numéricos , Hipófise/fisiologia , Estudos Prospectivos , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricosRESUMO
OBJECTIVE: The aim of this study was to compare 3 different doses of GnRH-a in a short protocol on ICSI outcome. METHODS: 91 ovulatory patients were randomly assigned to three groups; group A (N=34), group B (N=34) and group C (N=23). All started treatment with urinary gonadotropins, 2 ampoules per day and GnRH-a (Triptorelin) on the first day of the menstrual period and continued till the day of (hCG) administration. The daily dose of Triptorelin was 0.1 mg, 50 µg, and 25 µg in groups A, B and C respectively. RESULTS: Stimulation requirements, days of stimulation and total ampoules of gonadotropins did not differ between the three groups. The mean number of follicles aspirated and the mean number of Metaphase 2 oocytes retrieved were similar in the three groups. Fertilization and cleavage rates were similar in the three groups. The mean number of embryos available for transfer was 6.4±0.5, 9.4±0.5 and 7±0.7 in groups A, B and C, with a significant difference only between groups A and B. Pregnancy rates per cycle were 35.3%, 35.3% and 34.8 % for groups A, B and C, respectively with no significant difference. CONCLUSION: Early and late hormonal changes, stimulation requirements and final outcome were similar with the different doses of the agonist. Other factors should be considered, most importantly: treatment cost and side effects.