Ovulation Induction for In-Vitro-Fertilization and Embryo Transfer Applying Decapeptyl (DTRP-6 LH/RH) in Combination with HMG or FSH

Abstract

47 patients out of the IVF-program of the Department of Obstetrics and Gynecology University of Kiel, who demonstrated in previous stimulation cycles premature LH surges, were treated in two modalities with a down regulation applying the GnRN-analogue decapeptyl (DTRP-6 LH/RH) and a concomitant HMG- or FSH-stimulation. The down-regulation was started after ovulation up to a negative LH/RH test followed by a concomitant gonadotropin stimulation in group 1. In group 2 a parallel treatment with decapeptyl and HMG or FSH was performed from day 2 of the cycle. 10 husbands of the punctured patients had pathological sperm. In both groups 6 patients were discarded from of the stimulation protocol as their oestradiol responses were not adequate, sperm contamination was detected late in one case, and in one patient a premature LH surge occurred once again. In 36 patients vaginal follicular punctures were performed. With respect to pregnancies group 1 revealed a much higher pregnancy rate than group 2. It seemed better to start the down-regulation with the GnRH-analogue decapeptyl in the luteal phase of the previous cycle. The treatment with decapeptyl should not only be applied in patients with previous LH surges but also in order to establish a synchronous follicular maturation in ovulating patients treated for in-vitro fertilization, or gamete-intra-Falloppian-tube-transfer.

First Irish birth following IVF therapy using antagonist protocol

“…One initial complication of COH treatments was the presence of premature LH surges resulting in poor IVF outcome [5]. Multiple authors [6,7] have shown the benefits of GnRH-a use in preventing a premature LH surge in IVF. Yet, such therapy requires long duration (4 weeks) of administration and when the intranasal route is used, strict time keeping (6 hourly) with subsequent interference with normal life patterns.…”