Human Reproduction, Vol. 8, No. 5, pp. 695-698, 1993
© 1993 European Society of Human Reproduction and Embryology
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Premature luteinization is not eliminated by pituitary desensitization with leuprolide acetate in women undergoing gonadotrophin stimulation who demonstrated premature luteinization in a prior gonadotrophin-only cycle*
Mount Sinai Medical Center, Department of Obstetrics and Gynecology and Reproductive Sciences Box 1175, 1 Gustave L.Levy Place, New York, NY 10029, USA
Correspondence: 1To whom correspondence should be addressed at: Bethesda Fertility Center, 619 Oak Street, Cincinnati, OH 45206, USA
A total of 40 women who demonstrated premature luteinization (serum progesterone 
3.5 nmol/1 (1.1 ng/ml) on or before the day of human chorionic gonadotrophin (HCG) administration) during ovarian stimulation with human menopausal gonadotrophins (HMG) were restimulated in 46 subsequent cycles after pituitary desensitization with the gonadotrophin-releasing hormone agonist (GnRHa, 1 mg), leuprolide acetate. Five women were treated with a double dose of agonist (2 mg) when premature luteinization was determined on the single dose protocol. In HMG-only cycles, a frank luteinizing hormone (LH) surge was detected in 30 cycles; 15 cycles were cancelled because of premature ovulation. In agonist cycles there were no cancellations, although 25 cycles demonstrated premature luteinization and in six cycles a frank LH surge was detected. Doubling the dose of the agonist did not prevent premature luteinization. Agonist cycles with and without premature luteinization did not differ in any in-vitro fertilization (IVF) outcome parameters (ampoules of gonadotrophins, day of HCG administration, peak oestradiol concentration, number of oocytes retrieved, fertilized, transferred or cryopreserved). We conclude that in patients who demonstrate premature luteinization in a gonadotrophin-only cycle, pituitary desensitization may not completely eliminate subtle luteinization or a frank LH surge.
Key words: LH surge/ovarian stimulation/premature luteinization
*Presented at the 46th Annual Meetings of The American Fertility Society, Washington DC, October 15–18, 1990
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