HALF-DOSE DEPOT TRIPTORELIN COMPARABLE TO REDUCED DAILY BUSERELIN: A RANDOMIZED CLINICAL TRIAL

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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.