Clinical applications of different doses of leuprorelin acetate in in vitro fertilization-embryo transfer

Abstract

To evaluate the clinical effect of different doses of leuprorelin acetate in in vitro fertilization-embryo transfer (IVF-ET). From January 2011 to December 2011, the data of 268 patients undergoing IVF and(or) intracytoplasmic sperm injection (ICSI) in Reproductive Medical Center, Clinical College of PLA, Anhui Medical University were studied retrospectively. All the patients were divided into three groups based on with long protocol and controlled ovarian stimulation (COH) including 83 cycles with 1.25 mg of leuprorelin in low dose group, 68 cycles with 1.88 mg of leuprorelin in high dose group, 117 cycles with 1.25 mg of diphereline in control group. The serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E(2)) and progesterone (P) before gonadotropin (Gn) administration on the days 3-5 of the menstrual cycle and on the day of hCG administration were detected, the dose and duration of Gn, number of oocytes retrieved, number of mature oocytes, the rates of fertilization, embryo cleaved, good-quality embryos clinical pregnancy and early miscarriage were compared among three groups. There were no significant differences in age, the level of LH and P on the day of hCG administration among three groups (P > 0.05). The level of FSH was (3.8 ± 1.6) U/L in low dose leuprorelin group, (3.1 ± 1.4) U/L in high dose of leuprorelin group and (2.4 ± 1.3) U/L in diphereline group before Gn administration, which reached statistical difference (P < 0.05). The mean length of Gn stimulation were (9.8 ± 1.7) days in low dose leuprorelin group, (10.5 ± 1.8) days in high dose of leuprorelin group and (11.1 ± 1.4) days in diphereline group, which reached statistical difference (P < 0.05). The mean dose of Gn was (24 ± 7) in low dose of leuprorelin group, which was significantly higher than (27 ± 9) in high dose of leuprorelin group and (28 ± 7) in diphereline group (P < 0.05). The level of LH was (2.7 ± 1.6) U/L in low dose of leuprorelin group and (2.2 ± 1.0) U/L in diphereline group before Gn administration, which reached statistical difference (P < 0.05). The cancel cycles were 5 in low dose of leuprorelin group, 4 in high dose of leuprorelin group and 7 in diphereline group. The number of ovum was (14 ± 7) low dose of leuprorelin group, (13 ± 6) in high dose of leuprorelin group, (14 ± 6) in diphereline group. The rates of fertilization was 66.26% (758/1144) in low dose of leuprorelin group, 67.01% (589/879) in high dose of leuprorelin group and 68.54% (1111/1621) in diphereline group, the rates of good-quality embryos was 64.22% (472/735) in low dose of leuprorelin group, 60.50% (340/562) in high dose of leuprorelin group and 59.59% (640/1074) in diphereline group, clinical pregnancy was 49% (38/78) in low dose of leuprorelin group, 42% (27/64) in high dose of leuprorelin group and 50% (55/110) in diphereline group, early miscarriage was 18% (7/38) in low dose of leuprorelin group, 15% (4/27) in high dose of leuprorelin group and 15% (8/55) in diphereline group, which did not show significant differences (P > 0.05). Both 1.25 mg and 1.88 mg leuprorelin acetate could obtain good down-regulation effect and clinical outcomes. 1.25 mg leuprorelin acetate could decrease patient's costs by reducing Gn dose and duration.