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[Hypophyseal suppression and subsequent cycle stimulation: experiences in an in vitro fertilization program]
P Riss1, A Reinthaller, F Fischl
1II. Universitäts-Frauenklinik, Wien.
Geburtshilfe Und Frauenheilkunde
|May 1, 1989
Summary
A long-acting gonadotropin-releasing hormone (GnRH) agonist suppressed pituitary function but did not improve in-vitro fertilization (IVF) outcomes. While it increased progesterone and oocyte retrieval, fertilization rates were lower in the treated group.
Area of Science:
- Reproductive Endocrinology
- In-Vitro Fertilization
Background:
- Gonadotropin-releasing hormone (GnRH) agonists are used to induce a hypogonadotropic state.
- Understanding their impact on pituitary and ovarian function is crucial for optimizing fertility treatments.
Purpose of the Study:
- To evaluate the effect of a long-acting GnRH agonist on pituitary gonadotropin levels.
- To analyze serum steroid levels during subsequent cycle stimulation.
- To determine if this protocol improves in-vitro fertilization (IVF) program results.
Main Methods:
- 29 patients received a single 4 mg Decapeptyl CR injection followed by FSH/HMG/HCG stimulation (Group I).
- 35 patients underwent standard HMG/HCG stimulation (Group II).
- Serum LH, FSH, E2, and progesterone levels were monitored; urinary LH was also assessed.
Main Results:
- Decapeptyl CR significantly reduced LH, FSH, and E2 levels.
- Group I required threefold higher gonadotropin dosage and showed significantly higher progesterone levels.
- More oocytes were retrieved in Group I, but fertilization rates were significantly lower.
Conclusions:
- A single Decapeptyl CR injection effectively suppressed pituitary function.
- Despite pituitary suppression and increased oocyte retrieval, the protocol did not enhance overall IVF success rates.
- Lower fertilization rates were observed in the GnRH agonist group.