Biomedical Research

Objectives: Gonadotropin-releasing Hormone agonists (GnRHa) has been used for pituitary desensitization during Controlled Ovarian Hyperstimulation (COH)-In Vitro Fertilization (IVF) for decades. We aimed to determine the clinical differences between half and full-dosage Leuprolide Acetate (LA) during short protocol COH-IVF.

Methods: All COH-IVF individuals were divided: (1) LA 0.5 mg/day (age<38, n=32); (2) LA 0.25 mg/day (age<38, n=38); (3) LA 0.5 mg/day (age ≥ 38, n=30); (4) LA 0.25 mg/day (age ≥ 38, n=33). The gonadropin dosage, Luteinizing Hormone (LH) surge, Ovarian Hyperstimulation Syndrome (OHSS) risk, oocyte and embryo number, Clinical Pregnancy Rate (CPR), and Live Birth Rate (LBR) were compared.

Results: We observed the non-significantly trends of lower gonadotropin dosages and higher LH surges in the halfdosage GnRHa groups compared to full-dosage GnRHa groups. Gonadotropin dosages (IU)/E2 (pg/mL) on human Chorionic Gonadotropin (hCG) day/LH surges in each group were: (1) 1454.4/1653.6/0%; (2) 1419.6/1683.5/3%; (3) 1954.5/910.8%/0%; and (4) 1893.5/953.6/3.7% respectively. The oocyte number, day 3 embryo number, OHSS, and CPR, LBR were non-statistically different between full and half LA groups. The oocyte number/day 3 grade I, II embryo number/CPR/LBR in each group were: (1) 11.3/5.6/37.5%/31.3%; (2) 11.8/5.1/39.4%/33.3%, (3) 6.5/2.6/19.2%/11.5%; and (4) 6.8/2.7/22.2%/14.8%.

Conclusions: Half-dosage GnRHa application results in comparable pituitary suppression and clinical outcomes compared to full-dosage GnRHa during short IVF protocol. The real roles of lower-dosage GnRHa upon pituitary desensitization during IVF warrant further investigation.

Author(s): Jen-Hsiang Hsieh, Yao-Yuan Hsieh, Chi-Chen Chang, Tsung-Tao Huang, Ming-Hua Shiao, Tzu-Chieh Kao, Chang-Wei Li
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