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Human Reproduction, Vol. 8, No. 10, pp. 1628-1631, 1993
© 1993 European Society of Human Reproduction and Embryology

research-article

Endocrinology: Triggering of ovulation using a gonadotrophin-releasing hormone agonist does not prevent ovarian hyperstimulation syndrome

S. van der Meer1, J. Gerris, M. Joostens and B. Tas

Department of Obstetrics, Gynaecology and Fertility, Middelheim Hospital Lindendreef 1, 2020 Antwerpen, Belgium

Correspondence: 1To whom correspondence should be addressed

A total of 24 women with primary or secondary infertility due to oligo- or anovulation, were treated with human menopausal gonadotrophin (HMG). In 48 cycles, we used a gonadotrophin-releasing hormone agonist (GnRHa) nasal spray (buserelin) to induce a pre-ovulatory endogenous luteinizing hormone (LH) surge. In 44 cycles, there was a rapid rise of the serum LH concentration within 8 h from the first administration of GnRHa. One patient with pituitary hypogonadotrophic amenorrhoea showed a weak or no response in four treatment cycles. Conception occurred in 10 cycles (pregnancy/cycle (P/C) index = 22.7%), four of which ended in a spontaneous abortion and six of which are ongoing pregnancies. In 27 cycles, there was an increased risk for ovarian hyperstimulation syndrome (OHSS), defined as more than three follicles ≥ 18 mm in diameter and/or serum oestradiol > 1200 pg/ml. Three of these treatment cycles gave rise to the development of moderate OHSS in the absence of exogenously administered human chorionic gonadotrophin, two being conception cycles.

Key words: GnRH agonist/hyperstimulation syndrome/LH surge/ovulation induction


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