[Hormonal therapy for the synchronization between donor and recipient in an oocyte donation and surrogacy...

To evaluate the efficacy of hormonal therapy for the establishment of endometrium synchronous with the embryo in an oocyte donation and surrogacy fertilization in vitro-embryo transfer (IVF-ET) program.

The IVF-ET routine of the Beijing Medical University was employed. The recipients included cases with (1) premature menopause and (2) abnormal chromosomal karyotypes; surrogate mothers. For (1) surrogate mother, low constant doses of estradiol (E2) (17-beta estradiol-Estrace or E2 valerate) 2-4 mg was started 3-5 days before the expected menstruation of the donor progesterone (P) was started intramuscularly 30 mg daily from the day of hCG injection, 50 mg from the day of oocyte pick-up, 100 mg from the day of embryo transfer and 150 mg from the day of positive urinary beta-hCG; E2 was maintained at the 4 mg dose. Both E2 and P were continued until after the luteo-placental shift-about 90 to 100 days of pregnancy with gradual tapering doses. The serum E2 and P levels were measured by radioimmunoassay and compared with those of normal pregnancy. For (2) women with normal menstrual periods, the Chinese made gonadotropin-releasing hormone-A (GnRH-A) 400-600 micrograms was given for down-regulation of pituitary and artificial agonadism when at least amenorrhea of two months was achieved and a quiescent state of the endometrium and ovaries was ascertained by vaginal ultrasonography. Then the E2 and P therapy was started as described above. GnRH-A was stopped on the day of hCG injection.

In the hormonal therapy group, the serum E2 levels were quite similar to those of the normal pregnancy, while the P levels were about 3-5 times higher. Two full term deliveries of normal female babies and one in her 36th week of pregnancy were achieved in the premature menopause group. In the normal menstruation group, one was in her 15th week of pregnancy and the surrogate mother was in h34 4 1/2 months of pregnancy.

The proposed hormonal therapy to synchronize the donor and the recipient may be used with satisfactory clinical outcome in an oocyte donation and surrogacy IVF-ET program.