Document Detail


Clinical evaluation of three different gonadotrophin-releasing hormone analogues in an IVF programme: a prospective study.
MedLine Citation:
PMID:  12069736     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The efficacy and safety of short acting buserelin and nafarelin intranasal spray were compared to long acting leuprorelin depot intramuscular or subcutaneous injection in this prospective study of 157 women undergoing controlled ovarian hyperstimulation (COH) for in-vitro fertilisation (IVF). Patients were allocated to three groups to receive buserelin 150 microg nasal spray three times daily (Group B), nafarelin nasal spray 400 microg twice daily (Group N), or leuprorelin depot 3.75 mg once by intramuscular or subcutaneous injection (Group L) for pituitary desensitisation prior to commencing COH with human menopausal gonadotrophins (hMG) according to the Centre's protocol. The mean (+/-S.D.) age (years) (32.6+/-3.8: Group B, 32.1+/-3.3: Group N versus 32.1+/-3.3: Group L); mean (+/-S.D.) total dosage of hMG (ampoules) (37.5+/-16.1: Group B, 39.8+/-14.2: Group N versus 41.9+/-12.6: Group L) and mean daily dosage of hMG (ampoules) (3.1: Group B, 2.8: Group N versus 3.0: Group L) seen were not statistically significantly different. The duration between starting the different gonadotrophin-releasing hormone (GnRHa) and the beginning of the next menstrual period was also not seen to be statistically significantly different between the three groups (Group B: 10+/-5.5, Group N: 9.1+/-4.1 versus Group L: 8.2+/-3, days). The number of abandoned cycles was higher in Group L (17% versus 11.8%: Group B and 11.3%: Group N) but this difference did not reach statistical significance. The clinical pregnancy rates per oocyte retrieval and per embryo transfer procedure were respectively, 31.1, 35% in Group B, 12.8, 14% in Group N versus 20.5, 23.7 in Group L and were not seen to be statistically significantly different even when ongoing pregnancy rates were compared. Apart from a statistically significantly greater incidence of allergic nasal reactions in the nafarelin group (P=0.001), all other side-effects were not shown to be statistically significantly different between the three groups. We conclude that a single dose of leuprorelin depot can be considered to be as an equally effective alternative to multiple doses of buserelin or nafarelin for pituitary desensitisation in women undergoing COH for IVF.
Authors:
A El-Nemr; M Bhide; Y Khalifa; E Al-Mizyen; C Gillott; A M Lower; T Al-Shawaf; J G Grudzinskas
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  103     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-18     Completed Date:  2003-01-22     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  140-5     Citation Subset:  IM    
Affiliation:
Fertility Centre, Royal Hospitals NHS Trust, St Bartholomew's Hospital, West Smithfield, EC1A, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intranasal
Adult
Buserelin / administration & dosage,  adverse effects
Embryo Transfer
Female
Fertility Agents, Female / administration & dosage*,  adverse effects
Fertilization in Vitro
Gonadotropin-Releasing Hormone / analogs & derivatives
Humans
Leuprolide / administration & dosage,  adverse effects
Menotropins / therapeutic use
Nafarelin / administration & dosage,  adverse effects
Oocytes / physiology
Ovulation Induction / methods*
Pregnancy
Pregnancy Rate
Prospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fertility Agents, Female; 33515-09-2/Gonadotropin-Releasing Hormone; 53714-56-0/Leuprolide; 57982-77-1/Buserelin; 61489-71-2/Menotropins; 76932-56-4/Nafarelin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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