[A study of the controlled ovarian hyperstimulation using GnRH agonist and pure FSH in in vitro fertilization-embryo transfer and gamete intrafallopian transfer program].
The present study was undertaken to examine controlled ovarian hyperstimulation (COH) during an IVF-ET/GIFT program with GnRH agonist (GnRH-a) and pure FSH and with the conventional method. Pituitary desensitization was induced with a subcutaneous injection of GnRH agonist (leuprolide acetate) in 20 patients undergoing COH for oocyte recovery. These 20 patients had previously dropped out of our IVF-ET/GIFT program because of a low estradiol response or premature LH surge. Comparisons were made among the menstrual cycles of 20 drop-out patients, the same patients' cycles after GnRH-a and pure FSH administration (GnRH-a group), and the cycles of 20 non-drop-out patients (control group). After treatment with GnRH-a and pure FSH, Estradiol levels were increased (GnRH-a cycles:previous cycles, 1,520 +/- 416 pg/ml:416 +/- 209.1 pg/ml), while the premature LH surge was decreased (GnRH-a cycles:previous cycles, 2:12). Moreover, the number of follicles at the day of hCG injection was increased (GnRH-a group: control group, 4.6 +/- 1.3:3.4 +/- 1.5). However, the fertilization rates for the GnRH-a group and the control group did not differ markedly, though the pregnancy rate was increased slightly in the former (GnRH-a group:control group, 25%:15%). In conclusion, it was seen that COH using GnRH-a and pure FSH contributed to a better ovarian response and suppression of LH surge in patients who had previously dropped out of the IVF-ET/GIFT program using conventional ovarian stimulation.