Human Reproduction, Vol 12, 2118-2122, Copyright © 1997 by Oxford University Press
D Valbuena, A Pellicer, PP Guanes, J Remohi and C Simon
Previous studies have described the luteolytic effect of gonadotrophin-
releasing hormone agonist (GnRHa) administered in the early luteal phase.
The present work was undertaken to compare in a prospective and randomized
design the effect of disruption versus continuation of daily GnRHa after
human chorionic gonadotrophin (HCG) administration on corpus luteum
function in patients undergoing ovulation induction for in-vitro
fertilization (IVF). Two different studies were designed and a total of 38
ovum donors, aged 23-30 years, were included. In the first study, the
effect of GnRHa on the early luteal phase of IVF-stimulated cycles was
investigated (n = 27); the patients were divided into two groups, according
to whether they stopped (n = 13) or continued with daily GnRHa injections
(n = 14) for an additional period of 15 days after HCG administration.
Blood was drawn from luteal phase days 2 to 6 (day 0 = day of HCG
administration) and oestradiol and progesterone concentrations were
analysed. The second study focused on the effects of continuation versus
disruption of GnRHa administration in the mid- late luteal phase. A similar
design was employed including six patients who stopped GnRH on day 0 and
five other women who continued GnRHa for 15 days after HCG administration.
In this second study, blood was drawn from days 5 to 11 and oestradiol,
progesterone and luteinizing hormone (LH) concentrations were analysed. IVF
parameters were similar in both groups. The results indicate that
continuous GnRHa administration, after HCG injection, does not produce
changes in oestradiol, progesterone and LH concentrations in the early,
mid- and late luteal phases compared to those patients in whom GnRHa is
discontinued at the day of HCG administration. The present work
demonstrates that, when ovulation induction is performed, the corpus luteum
is driven primarily by the HCG, regardless of the administration or
disruption of GnRHa in the luteal phase. This suggests that the lack of
differences between continuation versus disruption of GnRHa may be due to
the accumulation of the product over the previous 2-3 weeks of treatment.
ARTICLES
Effect of disruption versus continuation of gonadotrophin-releasing agonist after human chorionic gonadotrophin administration on corpus luteum function in patients undergoing ovulation induction for in-vitro fertilization
Instituto Valenciano de Infertilidad, Department of Pediatrics, Obstetrics and Gynecology, Valencia University School of Medicine, Spain.
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