Human Reproduction, Vol. 9, No. 5, pp. 788-791, 1994
© 1994 European Society of Human Reproduction and Embryology
research-article |
Suppression of the endogenous luteinizing hormone surge by the gonadotrophin-releasing hormone antagonist Cetrorelix during ovarian stimulation
1Clinic for Gynaecology and Obstetrics of the University of Lübeck Lübeck 2University Clinic Bonn, 3 ASTA Medica AG, Frankfurt 4Institute for Clinical Biochemistiy, University of Bonn Germany
Correspondence: 5whom correspondence should be addressed
Surges of luteinizing hormone (LH) that result In luteinization but occur prematurely with respect to the diameter of the leading folilde, prevent attempts to induce multiple follicular maturation for in-vitro fertilization (IVF) in a significant number of women. We examined the possibility of blocking premature LII surges by the administration of Cetrorelix, a potent antagonist of gonadotrophin-releasing hormone (GnRH), in a study Including 20 patients, some of whom had previously shown premature LH surges. All patients were treated with human menopausal gonadotrophins (HMG) starting on day 2. From day 7 until the induction of ovulation by human chorionic gonadotrophin (HCG) the GnRII antagon Cetrorelix was given daily. HCG was injected when the dominant fofficle had reached a diameter of >18 mm and oestradlol concentration was >300 pg/ml for each follicle having a diameter of >15 mm. Oocyte collection was performed 36 h later by transvaginal ultrasound puncture, followed by IVF and embryo transfer. The hormone profiles of these patients and the results of IVF and embryo transfer are comparable to those treated with GnRH agonists and HMG. However, less time and especially less HMG Is needed in comparison to patients stimulated with a long agonist protocol. Hence, treatment with Cetrorelix proved to be much more comfortable for the patient. In this study we showed that combined treatment with gonadotrophins and the GnRH antagonist Cetrorelix is a promising method for ovarian stimulation in patients who frequently exhibit premature LH surges and therefore fall to complete treatment.
Key words: GnRH agonist/in-vitro fertilization/LH surge/ovulation induction
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