Journal
FERTILITY AND STERILITY
Volume 78, Issue 5, Pages 1068-1072Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0015-0282(02)03374-5
Keywords
GnRH antagonist; IVF; minimal stimulation; pregnancy rate
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Objective: To compare the results of a minimal-stimulation protocol with those of a standard protocol used for IVF. Design: Retrospective, controlled study. Setting: University center. Patient(s): Fifty-five patients undergoing IVF using a minimal-stimulation protocol with or without adjuvant therapy with a GnRH antagonist. A control group consisted of age- and diagnosis-matched patients undergoing a standard long GnRH agonist (GnRH-a)-gonadotropin stimulation during the same time period. Intervention(s): Clomiphene citrate and gonadotropins, with or without the GnRH antagonist ganirelix. Main Outcome Measure(s): Oocytes recovered and pregnancy rates. Result(s): The number of oocytes retrieved was significantly lower for the minimal-stimulation regimen compared with the case of the long GnRH-a protocol (4.8 +/- 2.6 vs. 16.2 +/- 7.5, respectively). The clinical pregnancy rate per transfer, however, was not significantly different between the two regimens (37% vs. 41%, minimal stimulation vs. long GnRH-a protocol, respectively). The addition of ganirelix resulted in at least the same pregnancy outcome as compared with the case of cycles without the antagonist. Conclusion(s): Minimal stimulation using clomiphene citrate followed by gonadotropin for IVF results in pregnancy rates equal to the standard long GnRH-a-gonadotropin protocol. The addition of ganirelix resulted in at least similar results with the advantage of eliminating the occurrence of a premature endogenous LH surge.
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