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Related Experiment Videos

Experience with GnRH agonists in an in vitro fertilization (IVF) program.

F Forsdahl1, N Holst, L J Hansen

  • 1Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tromsø, Norway.

Acta Obstetricia Et Gynecologica Scandinavica
|January 1, 1991
PubMed
Summary

Pre-treatment with gonadotropin-releasing hormone (GnRH) agonists improves outcomes in in vitro fertilization (IVF) programs for patients with specific previous cycle issues. This approach reduced cycle cancellations, particularly for those with a history of poor response.

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Area of Science:

  • Reproductive Endocrinology
  • In Vitro Fertilization (IVF)

Background:

  • Previous IVF cycles can be complicated by poor response, premature luteinizing hormone (LH) surges, or follicular luteinization.
  • Gonadotropin-releasing hormone (GnRH) agonists are used to prevent these complications through pituitary desensitization.

Purpose of the Study:

  • To evaluate the effectiveness of pre-treatment with GnRH agonists in IVF programs.
  • To assess the impact of GnRH agonist pre-treatment on cycle cancellation rates and pregnancy outcomes in specific patient populations.

Main Methods:

  • Sixty-eight IVF cycles were analyzed in 55 patients with a history of poor response, premature LH surge, or follicular luteinization.
  • GnRH agonist therapy was self-administered subcutaneously in the midluteal phase.
  • Ovarian stimulation with exogenous gonadotropins commenced after pituitary desensitization, with follicular punctures scheduled for weekdays.

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Main Results:

  • Overall cycle cancellation rate was 7.4%.
  • Patients with a history of 'poor response' had a significantly higher cancellation rate (36.4%) compared to other indications (1.8%, p < 0.001).
  • Twenty-six clinical pregnancies were achieved, resulting in a 33% delivery rate per oocyte retrieval and 40% per pre-embryo replacement.

Conclusions:

  • GnRH agonist pre-treatment is a viable strategy in IVF, particularly for patients experiencing premature LH surges or follicular luteinization.
  • While effective overall, careful consideration is needed for patients with a history of poor response due to higher cancellation rates.
  • The study demonstrates successful pregnancy and delivery rates using this pre-treatment protocol.