Early cessation of triptorelin in in vitro fertilization: a double-blind, randomized study

Objective: To compare the efficacy of two early cessation protocols of triptorelin treatment in controlled ovarian hyperstimulation with the conventional long protocol in in vitro ferfilization/intracytoplasmic sperm injection.

Design: A double-blind, randomized, multicenter study.

Setting: Three Dutch hospitals.

Patient(s): One hundred seventy-eight women randomized to one of three treatment groups at the start of stimulation.

Intervention(s): Midluteally started triptorelin administration was continued until the first day of hMG treatment (group S), or up to and including the fourth day of hMG treatment (group M) or the day of hCG injection (group L).

Main Outcome Measure(s): Occurrence of a premature LH surge.

Result(s): One premature LH surge was observed in group M but not in groups S and L. Both early cessation protocols (S and M) are at least as effective as the long protocol (L) with regard to the number of oocytes (11.1 and 10.3 vs. 9.3), number of embryos (7.3 and 6.5 vs. 5.5), and ongoing pregnancy rate (28% and 24% vs. 21%).

Conclusion(S): Early cessation of triptorelin on day 1 of hMG treatment in a midluteally started IVF protocol is as effective as the traditional long protocol in preventing a premature LH surge and results in similar fertility effects.