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Clomiphene-induced LH surges and cetrorelix
Jörg B Engel1, Ricardo E Felberbaum, Wiebke Eilers
1Department of Obstetrics and Gynecology, Medizinische Universität zu Lübeck, Lübeck, Germany, Ratzeburger Allee 160, 23538 Lübeck, Germany. joergbengel@hotmail.com
Reproductive Biomedicine Online
|November 7, 2002
Summary
Clomiphene citrate (CC) pretreatment enhances pituitary sensitivity to GnRH, reducing GnRH antagonist efficacy. Increasing GnRH antagonist dosage can overcome premature LH surges in IVF protocols.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization (IVF)
Background:
- Premature luteinizing hormone (LH) surges complicate IVF cycles using clomiphene citrate (CC) and GnRH antagonists.
- Understanding the interaction between CC and GnRH antagonists is crucial for optimizing stimulation protocols.
Purpose of the Study:
- To investigate the mechanism behind increased premature LH surges in CC-stimulated IVF protocols.
- To evaluate the effect of CC pretreatment on pituitary response to GnRH and GnRH antagonists.
Main Methods:
- Rat pituitary cells were pretreated with CC and stimulated with GnRH.
- Cells were co-administered varying concentrations of GnRH antagonist (cetrorelix).
- LH levels were compared between CC-pretreated and non-pretreated groups.
Main Results:
- CC pretreatment increased pituitary sensitivity to GnRH.
- Lower cetrorelix concentrations were less effective in suppressing LH in CC-pretreated cells.
- Higher cetrorelix concentrations effectively suppressed LH in both CC-pretreated and non-pretreated cells.
Conclusions:
- CC pretreatment alters pituitary responsiveness, necessitating higher GnRH antagonist doses to prevent premature LH surges.
- Adjusting GnRH antagonist dosage can mitigate the risk of premature LH surges in CC-based IVF protocols.