| Objectives To discuss the effectiveness of mini-stimulation protocol in in vitro fertilization and embryo transfer (IVF-ET) treatment.Methods One hundred and twenty one couples which accepted IVF or ICSI treatment from January 2006 to February 2007 were randomly divided into 3 groups: group A (GnRH-a long protocol), group B (GnRH-a short protocol), group C (GnRH-ant protocol).There were 42 cases in group A,41 cases in group B and 38 cases in group C. GnRH-a long protocol: GnRH-a (Alarelin) involved a subcutaneous use, given at a dose of 150μg/day from the middle leutein phase of the previous cycle to the day of HCG administration. Gonadotropin(Gn) was given once the patient was down regulated. GnRH-a short protocol: GnRH-a involved a subcutaneous use, given at a dose of 150μg/day from the day 2 of the menstrual cycle to the day of HCG administration ,Gn was given at a dose of 75IU/day and Clomiphen was given at a dose of 100mg/day on the same day of the cycle. Clomiphen was used for five days and the dose of Gn was adopted according to the transvaginal ultrasound scanning . GnRH-ant protocol: Gn was given at a dose of 75IU/day and Clomiphen was given at a dose of 100mg/day on the day 2 of the menstrual cycle, Clomiphen was used for five days and the dose of Gn was adopted according to the transvaginal ultrasound scanning,when the diameter of leading follicle is or more than 14mm,GnRH-ant(Cetrotide) was given at a dose of 0.25mg/day. Of all the groups Human chorionic gonadotropin was administered to the patients and Gn was not used when there were two follicles with a diameter is or more than 18mm as determined by transvaginal ultrasound. Transvaginal oocyte retrieved was performed 34-36hours after HCG administered. Embryo transfer was performed 48 hours after oocytes retrieved. Estradiol(Progynova) was gven to the patients of group B and group C at a dose of 6mg/day on the day of HCG administration and continued for two weeks after the day of embryo transfer.Results The total Gn ampoules ,the stimulated days, the endometrial thickness on the day of HCG administration, serum E2 level and LH level on the day of HCG administration and the number of retrieved oocytes of the three groups were 19.63±9.92, (12.87±5.66) and (11.05±3.96);(7.90±1.99),(8.81±1.47)and(8.16±1.24);(10.37±1.55) cm,(7.14±1.83)cmand(6.50±1.25)cm;(1.2049±1.21)IU/L,(3.4984±2.34)IU/Land(3.3034±2.5 3)IU/L;(7595.77±3693.30)pmol/L(8856.61±4988.06)pmol/Land(8141.32±6631.32)pmol/L; (9.66±3.58), (6.24±4.72)and (5.08±3.60) respectively. Of the total Gn ampoules, endometrial thickness, the number of retrieved oocytes there were significant difference between group A and group B, group A and group C(P<0.05);and no significant difference between group B and group C (P>0.05). The serum LH level on the day of HCG administration in the group A is significantly lower than group B and group C(P<0.05). Of the serum E2 level on the day of HCG administration , there was no significant difference between group A and group B, group A and group C, group B and group C (P>0.05).The rate of MII oocyte, fertilization rate, cleavage rate, pregnancy rate ,implantation rate and freezing rate of the three groups were 90.03% , 91.13% and 91.60%; 78.52% ,78.88%and 76.91 %; 84.21 % , 89.04 % and 93.60%; 68.30% , 42.90% and 39.50% ; 25.61%, 17.91%and28.13%; 41.50% ,23.80 % and 39.50 % respectively. And there was no significant difference between group A and group B , group A and group C, group B and group C (P>0.05).Conclusions The mini-stimulation IVF protocol have the similar clinical effectiveness with the GnRH-a long protocol and reduced the total Gn ampouls , the cost of a cycle treatment.
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