The present study was designed to investigate the effectivens of lowdose gonadotropinreleasing hormone agonist(GnRH-a) long protocol in poor responders with elevated basal level follicle stimulating hormone(FSH)(>8.5mIU/ml). From May 1994 to July
1995,
50 patients who were defined as poor responders on previous superovulation attempts were randomly allocated to the lowdose GnRH-a long protocol group(LD grup)(n=25) and the regular-dose GnRH-a long protocol(RD group)(N=25). The indications for
superovulation with intrauterine insemination(IUI) included ovulatory factor(n=34), unexplained infertility(n=8), and stage I, II endometriosis(n=8). Patients with male factor, polycystic ovarian syndrome, or hyperandrogenism were excluded from
this
study. Two groups were similar with respect to clinical features and basal FSH levels. There was no difference between two groups in cycle cancellation rate(0% vs 4.0%). The amount of gonadotropin required was significantly smaller in the LD
group,
with
43.3±12.0 ampules compared with 48.9±14.2 ampules in the RD group. The duration of gonadotropin administration was significantly shorter in the LD group, with 43.3±12.0 ampules compared with 48.9±14.2 ampules in the RD group. The duration of
gonadotropin administration was significantly shorter in the LD group, with 9.7±1.1 days compared with 10.6±1.2 days in the RD group. The mean estradiol level on the day of hCG administration in the LD group, 1102.8±301.2pg/ml was
significantly
higher than that in the RD group, 1010.1±247.1pg/ml . Patients in the LD group yielded a higher mean number of follicles(≥14mm) on the day of hCG administration than those in the RD group(6.9±2.6vs 6.0±1.9) It seemed that a clinical pregnancy
rate
per cycle was higher in the LD group, with 24.0%(6/25) compared with 12.5%(3/24) in the RD group, but this difference was not statistically significant. This study suggests that a lowdose GnRH-a long protocol is a better choice than regular-dose
GnRH-a
long protocol in poor responders undergoing superovulation with IUI.
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