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Pituitary down-regulation with the use of goserelin depot in cycles of controlled ovarian hyperstimulation for in vitro fertilization

Purpose: to verify the effects of the goserelin depot as GnRH agonist for hypophysis suppression, during the controlled ovarian hyperstimulation (COH) for in vitro fertilization and intrauterine embryo transfer (IVF & ET). Method: this is a prospective study of 110 cycles of 101 women. Goserelin depot was administered subcutaneously as a single dose; for some women (87 cycles) it was administered in the first phase of the menstrual cycle, and in 23 cycles it was administered in the luteal phase. The administration of menopausal gonadotropins was daily, until the identification of at least two follicles with a diameter equal to or larger than 18 mm; at this time the chorionic gonadotropin was administered and the follicular aspiration was programmed. Results: the women's age average was 36.7 years (between 23 to 42 years). The main indications for IVF & ET were: tubo-peritoneal factor (75.2%), endometriosis (10.9%), ovulatory factor (7.9%), male factor (3.0%) and unexplained infertility (3.0%). Of the total of the cycles, 28 (25.5%) cycles were cancealed. In 7 cycles (8.04%), for which goserelin depot was administered in the first phase of the menstrual cycle, it was necessary to perform the ovarian cysts aspiration before beginning the ovulation induction. On the average, 3.3 embryos were transferred for each patient (1-5 embryos per woman). Of the total of 70 embryos transferred, 16 clinical pregnancies resulted (pregnancy rate: 22.85%). Conclusion: the goserelin depot administration is a useful alternative for pituitary suppression for IVF & ET, since its results are similar to those observed in the literature, and the patient does not need to come every day to receive medication, a fact of extreme importance in a public service.

Ovulation; Ovulation Induction; Gonadotropins; Fertilization in vitro; Embryo Transfer


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