Randomized trial of three luteinizing hormone-releasing hormone analogues used for ovarian stimulation in an in vitro fertilization program

Objective To determine if biochemical differences in luteinizing hormone-releasing hormone analogues (LH-RH-a) have a clinical influence, we studied three of these molecules: buserelin acetate (group B), triptorelin (group T), and leuprorelin (group L). Design Clinical trial. Setting In Vitro Fertilization (IVF) Center. Patients Two hundred forty-six patients, undergoing their first IVF attempt, were randomly allocated to one group. The analogues were used in a long protocol for ovarian stimulation in an IVF program. Results After 15days of LH-RH-a therapy, the follicle-stimulating hormone level was lower in group B (2.9±1, 4.3±1.7, 4.8±2.1 UI/L for B, T, and L groups, respectively; P 2 ) levels. After follicular growth stimulation by human menopausal gonadotropins (hMG), E 2 level was significantly lower in B group (1,799±1,101, 2,440±1,298, 2,137±1,044pg/mL for B, T, and L groups, respectively; P 2 level per hMG ampule (67±51, 97±61, 82±49 for B, T, and L groups respectively; P Conclusions These results suggest that LH-RH-a could act not only on the pituitary but also on the ovaries. Moreover, these data suggest that buserelin acetate could be preferentially used for high responders and triptorelin for poor responders.