Gonadotropin-releasing hormone and its analogues: applications in gynecology

In ovulation induction with hMG for IVF, clinical advantage has been taken of the agonistic ability of GnRH-a and its hypothalamic downregulating effect. This allows a better follicular synchronization, which represents an increase in the number and quality of oocytes and a decrease in the number of cancelled IVF cycles. Furthermore, according to the E2 response during the first 5 days of stimulation, the leuprolide screening test allows us to individualize ovarian stimulation for IVF and helps to prevent the potential risk of multiple pregnancy. In our experience, the majority of patients undergoing IVF benefit from the flare-up protocol, with the exception of the patients with an E2 pattern C response who benefit from the LPL protocol.