Short term use of an LHRH agonist to treat poor responders entering an in-vitro fertilization programme

Abstract

Seven patients who had previously responded poorly to stimulation with clomiphene citrate (CC) and human menopausal gonadotrophin (HMG) and also exhibited high tonic urinary LH output (> 0.25 IU/h) were given an LHRH agonist (500 μg/daily) on days 1 to 3 of the menstrual cycle followed by exogenous gonadotrophin stimulation. During the latter stages of follicular development plasma and urinary LH output were significantly lower (P < 0.01) than in the previous CC/MMG stimulated cycle. All seven patients had oocytes recovered, and embryos replaced. Three out of these seven became pregnant. To conclude, the efficacy of short term LHRH agonist treatment is equivalent to present longer term modes of administration in reducing gonadotrophin secretion and inhibiting the LH surge. The more widespread adoption of this abbreviated protocol could improve the prognosis for patients undergoing IVF in centres where facilities for intensive endocrine monitoring are not available.