Ovarian stimulation for in-vitro fertilization combining administration of gonadotrophins and blockade of the pituitary with D-Trp6-LHRH microcapsules: Pilot studies with two protocols

Jean René Zorn, Madalena Barata, Charles Brami, Sylvie Epelboin, Catherine Nathan, Georges Papageorgiou, Patrice Quantin, Francois Rolet, Michèle Savale, Pierre Boyer, Arlette Guichard, Lise Cedard, Anna Maria Comaru-schally, Andrew V. Schally

Research output: Contribution to journalArticle

37 Scopus citations

Abstract

In women undergoing in-vitro fertilization and embryo transfer (IVF-ET), a total of 408 IVF cycles were stimulated using human menopausal gonadotrophin (HMG) or pure follicle stimulating hormone (FSH) plus HMG in combination with a single injection of D-Trp6-LHRH microcapsules in order to enhance the ovarian response to gonadotrophins and to avoid spontaneous LH surges. Sixty-seven pregnancies were achieved. Two protocols were employed. In protocol 1 ('blocking protocol', n = 268), the pituitary was first inhibited with a full dose (3.75 mg) of D-Trp6-LHRH in microcapsules and ovarian stimulation was started after the hypogonadotrophic hypogonadal state was ascertained (E2 <50 pg/ml). In protocol 2 ('flare-up protocol', n = 140), the treatment with D-Trp6-LHRH microcapsules (half-dose = 1.80 mg) and the ovarian stimulation with gonadotrophins were started at the same time. Higher doses of gonadotrophins were needed (39.5 ± 11.2 ampoules FSH and/or HMG) in protocol 1, in which the pituitary was blocked prior to and during the stimulation, than in protocol 2 (20 ± 9 ampoules) where the exogenous gonadotrophin stimulation appeared to be augmented by the initial agonistic effect of the injection of D-Trp6-LHRH microcapsules. In patients with purely tubal infertility, under 38 years old and no male factor, the results obtained with protocols 1 and 2 were similar in terms of pregnancy rate per cycle or per embryo transfer: 22.6 versus 20.5% and 28.3 versus 27.4%, respectively. However, considering the cost benefit, 'flare-up' protocols appeared to be a better choice and could be recommended.

Original languageEnglish (US)
Pages (from-to)235-239
Number of pages5
JournalHuman Reproduction
Volume3
Issue number2
DOIs
StatePublished - Feb 1988

Keywords

  • IVF-ET
  • LHRH analogues
  • Ovarian stimulation
  • Pituitary blackade

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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  • Cite this

    Zorn, J. R., Barata, M., Brami, C., Epelboin, S., Nathan, C., Papageorgiou, G., Quantin, P., Rolet, F., Savale, M., Boyer, P., Guichard, A., Cedard, L., Comaru-schally, A. M., & Schally, A. V. (1988). Ovarian stimulation for in-vitro fertilization combining administration of gonadotrophins and blockade of the pituitary with D-Trp6-LHRH microcapsules: Pilot studies with two protocols. Human Reproduction, 3(2), 235-239. https://doi.org/10.1093/oxfordjournals.humrep.a136684