Human Reproduction, Vol 13, 561-564, Copyright © 1998 by Oxford University Press
D de Ziegler, AS Jaaskelainen, PA Brioschi, R Fanchin and C Bulletti
We have previously observed that exogenous oestradiol can delay the
intercycle increase in plasma follicle stimulating hormone (FSH). The
increase in plasma FSH that follows discontinuation of exogenous oestradiol
peaks after 3 days. We have now studied the possibility of using exogenous
oestradiol to synchronize the increase in endogenous FSH with the onset of
human menopausal gonadotrophin (HMG) treatment in controlled ovarian
hyperstimulation (COH). A total of 30 women aged 35.1+/-6.3 years
(mean+/-SD) undergoing ovarian stimulation received 2 mg of oestradiol
valerate twice daily starting on day 25 of the previous menstrual cycle
until the first Tuesday following menses. Ovarian stimulation was initiated
3 days later. On the last day of oestradiol treatment, plasma oestradiol,
FSH and luteinizing hormone (LH) (mean+/-SEM) were 566+/-53 (pmol/l),
3.8+/-0.4 (IU/l) and 5.5+/- 0.8 (IU/l) respectively. After 3 days, the FSH
and LH (mean+/-SEM) had increased to 6.7+/-0.7 and 6.9+/-0.7 (IU/l)
respectively while oestradiol decreased to 251+/-29 (pmol/l). The mean
number (+/-SEM) of HMG ampoules used was 25.1+/-2.7 and treatment lasted
11.3+/-0.9 days. Five women became pregnant for a pregnancy rate (ongoing)
of 19 (15)%. If all women aged >40 years (six women who did not become
pregnant) were excluded from analysis the pregnancy rate (ongoing) was 24
(19%). These results indicate that exogenous oestradiol can safely be used
for the synchronization of endogenous and exogenous FSH stimuli in COH.
This approach provides the practical advantage of permitting an advanced
timing of the onset of COH treatments when gonadotrophin- releasing hormone
(GnRH) agonists are not used, which improves treatment convenience for
patients and team members alike. Further development of this model may
enable control of the onset of natural cycles which may find practical
applications for timing assisted reproductive techniques (intrauterine
insemination or in-vitro fertilization) in the natural cycle.
ARTICLES
Synchronization of endogenous and exogenous FSH stimuli in controlled ovarian hyperstimulation (COH)
Department of OB/GYN, Hospital of Nyon, Switzerland.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J.A. Huirne, R. Homburg, and C.B. Lambalk Are GnRH antagonists comparable to agonists for use in IVF? Hum. Reprod., November 1, 2007; 22(11): 2805 - 2813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Cedrin-Durnerin, B. Bstandig, I. Parneix, V. Bied-Damon, C. Avril, C. Decanter, and J.N. Hugues Effects of oral contraceptive, synthetic progestogen or natural estrogen pre-treatments on the hormonal profile and the antral follicle cohort before GnRH antagonist protocol Hum. Reprod., January 1, 2007; 22(1): 109 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.A. Huirne, J.N. Hugues, C. Pirard, F. Fischl, J.C. Sage, J.L. Pouly, A. Obruca, D.M. Braat, A.C.D. van Loenen, and C.B. Lambalk Cetrorelix in an oral contraceptive-pretreated stimulation cycle compared with buserelin in IVF/ICSI patients treated with r-hFSH: a randomized, multicentre, phase IIIb study Hum. Reprod., June 1, 2006; 21(6): 1408 - 1415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. M. Kolibianakis, E. G. Papanikolaou, M. Camus, H. Tournaye, A. C. Van Steirteghem, and P. Devroey Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial Hum. Reprod., February 1, 2006; 21(2): 352 - 357. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fanchin, L. Salomon, A. Castelo-Branco, F. Olivennes, N. Frydman, and R. Frydman Luteal estradiol pre-treatment coordinates follicular growth during controlled ovarian hyperstimulation with GnRH antagonists Hum. Reprod., December 1, 2003; 18(12): 2698 - 2703. [Abstract] [Full Text] [PDF]
|
|