A comparison of clomiphene/menotropins and D-Trp⁶-LH-RH/menotropins cycles of IVF-ET in the same patients

Pituitary suppression by long-acting D-Trp⁶-LH-RH and concomitant hMG ovarian stimulation for in vitro fertilization and embryo transfer (ET) has been used in 19 patients who previously failed to conceive, following ovarian stimulation by clomiphene citrate and hMG. When available, up to five embryos were transferred. Compared with the previous CC/hMG cycles, D-Trp⁶-LH-RH/hMG cycles were associated with significantly more embryos (P < .002), lower follicular-phase basal LH levels (P < .05), and a higher early luteal progesterone level (P < .05). Following D-Trp⁶-LH-RH/hMG cycles, 11 patients had a clinical pregnancy. The multiple pregnancy rate was 18% and the abortion rate, 18%. Thirty percent of the cycles (6/20) were associated with the ovarian hyperstimulation syndrome. These promising results warrant a further trial of D-Trp⁶-LH-RH-hMG stimulation.