Objective: To compare cycle outcomes among normal-responding patients <or=30 years old receiving microdose follicular flare (MDF) and long-luteal agonist (LL).
Design: Retrospective cohort study.
Setting: Military-based assisted reproductive technology (ART) center.
Patient(s): First autologous ART cycles among 499 women <or=30 years old from January 1999 to December 2005.
Intervention(s): After oral contraceptive pill (OCP) administration before cycle start, patients were nonrandomly assigned to either LL or MDF for LH surge suppression. Patients in the LL group received 1 mg/day leuprolide acetate (LA) on cycle day 21, which was reduced to 0.25 mg/day 10-14 days later. Patients in the MDF group received LA (40 microg twice a day) beginning 3 days after discontinuing OCPs. Both groups received a combination of hMG and recombinant FSH.
Main outcome measure(s): Primary outcomes were implantation, clinical pregnancy, and live-birth rates; in-cycle variables included peak E(2), oocytes retrieved, oocyte maturity, and fertilization rate.
Result(s): Multivariable models controlling for confounding by treatment indication found no significant differences between groups in implantation (MDF, 36%; LL, 38%), clinical pregnancy (MDF, 53%; LL, 56%), and live-birth rates (MDF, 47%; LL, 50%). No differences were observed in peak E(2), oocytes retrieved, oocyte maturity, fertilization rate, or embryos transferred.
Conclusion(s): MDF use among normal-responding ART patients produced no differences in cycle outcome when compared with LL. Therefore, MDF may be a viable alternative for normal-responding patients.