Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
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Assisted Conception: Preparing the Ovaries for Eggs Collection and Determination of the Outcome in Frozen Embryos Transfer (FET) During Natural Cycle IVF

Mustafa Zakaria*, Marcuse F. Steven*, Noureddine Louanjli, Wassym R. Senhaji, Abdelhafid Natiq, Mohammed Zarqaoui

The degree of pituitary suppression during treatment with the GnRHa triptorelin (Decapeptyl) is dose dependent. 0.05 mg triptorelin causes pituitary desensitization comparable to that of a dose of 0.1 mg. Reduction of the triptorelin dose to 0.025 mg forms a state of pituitary desensitization that is less profound than the higher doses used. Restoration of the spontaneous and stimulated LH release is slow and also dose dependent, while restoration of FSH stimulated release is more rapid, and independent of the triptorelin dose used. Long Protocol - Disadvantages of the GnRHa long protocol *Long treatment period until suppression is achieved. *Higher doses and longer duration of gonadotropin therapy which subsequently increase the total cost of the treatment. *Increased risk of ovarian hyperstimulation syndrome (OHSS). Advantages of the GnRHa long protocol. *Prevents a premature LH surge during exogenous gonadotropin stimulation. *Higher pregnancy rate in the long protocol, as compared to a short or ultrashort protocol. *Synchronization of recruited follicles. Pituitary gonadotropin secretions are blocked upon desensitization when a continuous GnRH stimulus is provided by means of an agonist or when the pituitary receptors are occupied with a competitive antagonist. GnRH antagonists were not available originally; therefore, prolonged daily injections of agonist with its desensitizing effect were used.