Half-dosage of gonadotropin-releasing hormone agonist is effective for pituitary desensitization during short IVF protocol

Objectives Gonadotropin-releasing hormone agonist (GnRHa) has been used for pituitary desensitization during controlled ovarian hyperstimulation (COH)-IVF for decades. We aimed to determine the clinical differences of half-dosage leuplin accete (LA) with the full-dosage in pituitary desensitization during short protocol COH. Methods All COH-IVF individuals who accepted LA for pituitary down-regulatioin were recruited. Women were divided: (1) LA 0.5 mg/day (age < 38, n = 32); (2) LA 0.25 mg/day (age < 38, n = 38); (3) LA 0.5 mg/day (age ≥ 38, n = 30); (4) LA 0.25 mg/day (age ≥ 38, n = 33). The gonadropin dosage, LH surge, OHSS risk, oocyte and embryo No., clinal pregnancy rate (CPR), and live birth rate (LBR) between each group were compared. The trial registration number and date of registration trial were retrospectively collected. Results The non-significantly trends of lower gonadotropin dosages and higher LH surges in the half-dosage GnRHa groups compared to full-dosage GnRHa groups were observed. Gonadotropin dosages (IU)/ E2 (pg/mL) on hCG day/LH surges in each group were: (1) 1454.4/1653.6/0%; (2) 1419.6/1683.5/3%, (3) 1954.5/910.8%/0%; and (4) 1893.5/953.6/3.7%; respectively. The oocyte No., day3 embryo No., ovarian hyperstimulation syndrome (OHSS), and CPR, LBR between half and full dosage were not statistically different between full & half LA groups. The oocyte No./day3 grade I, II embryo No/CPR/LBR in each group were: (1) 11.3 /5.6/37.5%/31.3%; (2) 11.8/5.1/39.4%/33.3%, (3) 6.5/2.6/19.2%/11.5%; and (4) 6.8/2.7/22.2%/14.8%; respectively. Conclusions Half-dosage GnRHa application results in comparable pituitary suppression and clinical outcomes compared to full-dosage GnRHa during short IVF protocol. The real roles of lower-dosage GnRHa upon pituitary desensitization during IVF warrant further investigation.