PURPOSE: We performed a prospective randomized study to assess the effects of a GnRH agonist (GnRH-a) on follicular development and steroidogenesis during controlled ovarian hyperstimulation (COH). METHODS:Patients undergoing in vitro fertilization (IVF) for tubal infertility receivedhuman menopausal gonadotropin (hMG) stimulation with or without the GnRH-a, buserelin, beginning in the midluteal phase of the prior cycle. We analyzed serum hormone levels, follicular development, and outcome of IVF. RESULTS: The mean number of retrieved oocytes was significantly greater, and the implantation rate per embryo was significantly higher, in the GnRH-a/hMG group (n = 101) than in the hMG-only group (n = 97). The concentration of androstenedione (A) and the A/estradiol ratio in the serum were significantly lower in the GnRH-a treatment group throughout the follicular phase. CONCLUSIONS: The concomitant use of GnRH-a during COH prevents atretic change of the follicles and enhances follicular development by reducing androgen accumulation, resulting in a higher developmental competence of the oocytes.
RCT Entities:
PURPOSE: We performed a prospective randomized study to assess the effects of a GnRH agonist (GnRH-a) on follicular development and steroidogenesis during controlled ovarian hyperstimulation (COH). METHODS:Patients undergoing in vitro fertilization (IVF) for tubal infertility received human menopausal gonadotropin (hMG) stimulation with or without the GnRH-a, buserelin, beginning in the midluteal phase of the prior cycle. We analyzed serum hormone levels, follicular development, and outcome of IVF. RESULTS: The mean number of retrieved oocytes was significantly greater, and the implantation rate per embryo was significantly higher, in the GnRH-a/hMG group (n = 101) than in the hMG-only group (n = 97). The concentration of androstenedione (A) and the A/estradiol ratio in the serum were significantly lower in the GnRH-a treatment group throughout the follicular phase. CONCLUSIONS: The concomitant use of GnRH-a during COH prevents atretic change of the follicles and enhances follicular development by reducing androgen accumulation, resulting in a higher developmental competence of the oocytes.
Authors: J Latouche; M Crumeyrolle-Arias; D Jordan; N Kopp; B Augendre-Ferrante; L Cedard; F Haour Journal: Endocrinology Date: 1989-09 Impact factor: 4.736
Authors: D R Meldrum; Z Tsao; S E Monroe; G D Braunstein; J Sladek; J K Lu; W Vale; J Rivier; H L Judd; R J Chang Journal: J Clin Endocrinol Metab Date: 1984-04 Impact factor: 5.958