Half-dose depot triptorelin comparable to reduced daily buserelin: a randomized clinical trial

ABSTRACT

Pituitary suppression by depot GnRH agonist may be excessive for ovarian stimulation. This study compares the efficacy of a single half-dose depot triptorelin and reduced-dose daily buserelin in a long protocol ICSI/ET. A total of 182 patients were randomized into two groups using sealed envelopes. Pituitary desensitization was obtained in group 1 [91 patients] with half-dose [1.87 mg] depot triptorelin in the mid-luteal phase of their menstrual cycle, and in group 2 [91 patients] with standard daily dose [0.5 mg] buserelin, which was then reduced to 0.25 mg at the start of human menopausal gonadotropin [HMG] stimulation. No significant differences were found among those who received HCG in terms of clinical pregnancy rate [34.4% in both groups], implantation rate [14.8% in group 1 versus 11.1% in group 2], fertilization rate [93.3 versus 95.6%], poor response rate [11.1 versus 6.7%], and miscarriage rate [11.1 versus 7.8%]. No significant differences were seen in number of HMG ampoules used, follicles at HCG administration, and oocytes retrieved. The number of days of stimulation was significantly reduced in group 2 [11.2 +/- 1.8 in group 1 versus 10.6 +/- 1.9, P = 0.030]. A half-dose of depot triptorelin can be successfully used in ovarian stimulation instead of reduced-dose daily buserelin, with more patient comfort and reduced stress and cost of injections