Gonadotropin-releasing hormone agonists (GnRH-a) vary in structure and route of administration. We performed this study to compare patient response to intranasal nafarelin acetate versus subcutaneous triptorelin as adjncts to ovulation induction
for in
vitro fertilization(IVF). From October 1995 to May 1996, sixty-four patients with tubal factor infertility entering their 79 cycles of IVF were randomized to receive either intranasal nafarelin acetate(Group I, 38 cycles) or subcutaneous
triptoreline(Group II, 41 cycles). Controlled ovarian nyperstimulation(COH) using luteal long protocol of GnRH-a was used in all patients. Patient characterisitics in the two groups did not differ significantly, nor did sperm parameters or
endocrine
profiles. There was no significant difference in ovarian response as indicated by duration of GnRH-a administration before ovarian stimulation, number of ampules of gonadotropin used and duration of gonadotropin administration in ovarian
stimulation,
and serum E2 level and number of follicles(≥14mm) on the day of hCG administration between the two groups. There were no significant differences in clinical results of oocyte and embryo obtained such as number of oocytes retrieved, oocytes
fertilized,
embryos cleaved, embryos frozen, and embryos transfered between the two groups. There were also no significant differences between group I and group II in clinical pregnancy rate(31.6% versus 34.1%) and abortion rate per clinical pregnancy (8.3%
versus
14.3%).
This study suggests that intranasal nafarelin acetate as well as subcutaneous triptorelin can be used successfully in ovulation induction using luteal long protocol of GnRH-a
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