كوتاه اثر براي مهار هيپوفيز GnRH-a طولاني اثر در مقايسه با تزريق روزانه GnRH-a تاثير دوزكم

EFFICACY OF LOW DOSE, LONG ACTING GONADOTROPIN RELEASING RELEASING HORMONE ANALOGUES (GnRH-a) IN ART CYCLES AND ITS EFFECT ON REDUCTION OF COST AND STRESS

Introduction: One of the most important aspects of every ART cycle is retrieval of good quality oocytes capable of good division that are accessed by selection of the best ovulation induction protocol on the basis of patients condition, age and cause of infertility. The aim of this study was evaluation of efficacy of low dose long acting GnRH-a (Decapeptyle) in prevention of premature LH surge and comparison of the outcome of ART with long protocol of short acting Gn-Rha (Buserekin). Materials & Methods:In this prospective, randomized clinical trial performed in Yazd IVF center, a total of 60 patients with 61 cycles of ART were included in this study. Patients with endometriosis and those older than 40 years were excluded. Patients underwent COH-ET. 30 patients in group 1 received a single half dose of Decapeptyle (1.87mg) in mid-luteal phase and 31 patients in other group received Buserelin (0.5 mg) from previous mid - luteal phase which was reduced to 0.25mg at start of gonadotropin administration. The number of oocytes, embryo, fertilization, Cleavage, pregnancy and cancellation rate were compared in the 2 groups. Results: There was no case of cancellation due to premature LH surge in two groups, but one cycle in group 1 was cancelled due to follicular growth. There were no significant differences in fertilization, cancellation and pregnancy rate and the gonadotropin dosage was the same in both the two groups. Oocyte quality was better in group 2 (84.3% VS 77.2, Pvalue <0.05), but cleavage rate (71.1% VS 81.9%,pvalue <0.01) and embryo development (85.6% VS 94.1%, Pvalue<0.05) were lower in group 1 than long acting Gn-RH-a group. Conclusion:On the basis of findings, we concluded that low dose long acting Gn-RH-a is a useful method for pituitary suppression and facility of use and low cost of cycle are its benefits. On the other hand, long acting Gn-RH-a has no effect on oocyte quality, embryo development and luteal phase.