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Endocrine profiles and luteal function during GnRH-analogue/HMG therapy
W Braendle1, C Lindner, V Lichtenberg
1Abteilung für klinische und experimentelle Endokrinologie, Universitäts-Frauenklinik, Hamburg, FRG.
Human Reproduction (Oxford, England)
|November 1, 1989
Summary
Pretreatment with gonadotrophin releasing hormone agonists (GnRH-a) significantly improves pregnancy rates in fertility treatments. This method enhances ovarian response and offers greater flexibility in ovulation induction protocols like IVF.
Area of Science:
- Reproductive Endocrinology
- Infertility Treatment
Background:
- Gonadotrophin therapy for ovulation induction can be complicated by premature luteinizing hormone (LH) surges.
- Inadequate ovarian response and cycle cancellations are challenges in standard gonadotrophin stimulation protocols.
Purpose of the Study:
- To evaluate the efficacy of pretreatment with gonadotrophin releasing hormone agonists (GnRH-a) in improving pregnancy rates.
- To assess the impact of GnRH-a on ovarian stimulation and LH dynamics during assisted reproductive technologies.
Main Methods:
- Comparison of pregnancy rates and cycle outcomes between patients treated with human menopausal gonadotrophin/human chorionic gonadotrophin (HMG/HCG) alone versus those pretreated with GnRH-a (buserelin or triptorelin).
- Analysis of LH surge occurrence and fluctuation patterns during ovarian stimulation in cycles with and without GnRH-a pretreatment.
Main Results:
- Pregnancy rates per patient were 17% (HMG/HCG), 25% (buserelin), and 25% (triptorelin).
- Pregnancy rates per cycle were 5.5% (HMG/HCG), 15% (buserelin), and 22% (triptorelin).
- GnRH-a pretreatment led to more intense ovarian reactions and reduced incidence of premature LH discharge (16%) and irregular LH fluctuation (18%) compared to HMG/HCG alone.
Conclusions:
- GnRH-a pretreatment significantly enhances pregnancy rates and improves ovarian response during gonadotrophin stimulation.
- Pituitary suppression with GnRH-a offers practical advantages, including flexible cycle initiation and HCG administration timing, reducing cycle cancellations for ovulation induction.