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Human Reproduction, Vol. 16, No. 12, 2533-2539, December 2001
© 2001 European Society of Human Reproduction and Embryology

Human ovarian steroid secretion in vivo: effects of GnRH agonist versus antagonist (cetrorelix)

Juan A. Garcia-Velasco1,4, Verónica Isaza1, Carmen Vidal2, Adriana Landazábal1, José Remohí2,3, Carlos Simón2,3 and Antonio Pellicer2,3

1 IVI-Madrid, Madrid, 2 Instituto Valenciano de Infertilidad (IVI) and 3 Department of Paediatrics, Obstetrics and Gynaecology, Valencia University School of Medicine, Valencia, Spain

BACKGROUND: In order to investigate whether gonadotrophin-releasing hormone (GnRH) antagonists exert a significant effect on steroid secretion in vivo compared with GnRH agonists, concentrations of sex steroid hormones (oestradiol, progesterone and testosterone) were studied in follicular fluid from women undergoing ovarian stimulation and treated with either GnRH agonist or antagonist. In addition, the correlation between follicular fluid steroid hormone concentrations and variables of follicular and oocyte development was evaluated. METHODS: Microparticle enzyme immunoassay and radioimmunoassays were used. RESULTS: The mean (SEM) follicular fluid oestradiol concentration was significantly lower in patients treated with GnRH antagonist than in those treated with GnRH agonist (542.0 ± 76.9 versus 873.0 ± 105.1 pg/ml, P = 0.02), which correlates with the mean serum oestradiol concentrations found in these two groups. No significant differences were found between groups in follicular fluid progesterone concentrations. Women undergoing GnRH antagonist treatment showed similar concentrations of follicular fluid testosterone compared with GnRH agonist-treated women (14.8 ± 1.1 versus 13.3 ± 2.7 ng/ml). The oestradiol:testosterone ratio was markedly reduced in women treated with GnRH antagonist (49.1 ± 2.3 versus 60.1 ± 4.4, P = 0.04). In contrast, no differences were found either in the progesterone:testosterone ratio, or in the oestradiol:progesterone ratio. CONCLUSIONS: GnRH antagonist therapy in women undergoing ovarian stimulation had a significant effect on ovarian follicular steroidogenesis.

Key words: follicular fluid/GnRH antagonist/IVF/steroid hormones

4 To whom correspondence should be addressed at: IVI-Madrid, C/Santiago de Compostela 88, 28035 Madrid, Spain. E-mail: jgvelasco{at}ivi.es


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