The effect of gonadotropin-releasing hormone agonist on the ovarian response and in vitro fertilization results in polycystic ovarian syndrome: a prospective study.
OBJECTIVE
To assess the effect of gonadotropin-releasing hormone agonist (GnRH-a) on pituitary suppression, subsequent ovarian response, and results of in vitro fertilization (IVF) treatments in polycystic ovarian syndrome (PCOS) patients.


METHODS
Randomized prospective study.


METHODS
In vitro fertilization program and endocrinologic institute.


METHODS
Thirty patients with PCOS; 16 received GnRH-a, and 14 did not receive GnRH-a.


METHODS
Ovum pick-up and embryo transfer.


METHODS
Response to GnRH-a test, serum and follicular fluid (FF) hormonal measurements, steroid levels, and aromatse activity in granulosa cell (GC) culture, and results of IVF.


RESULTS
Pituitary responsiveness was abolished in all patients 14 days after GnRH-a administration, and early luteinization was prevented. Steroid levels in FF did not differ between the two groups. In GC culture, progesterone (P) levels were higher in patients without the GnRH-a (3,704 +/- 1,232 nmol/L versus 2,117 +/- 235 nmol/L; P less than 0.05) as were androstenedione (A) levels (5.3 +/- 1.0 nmol/L versus less than 3.5 nmol/L; P less than 0.05). However, aromatase activity and IVF results were similar in the two groups.


CONCLUSIONS
Administration of GnRH-a in patients with PCOS decreases P and A production by the GC cells and prevents early luteinization. It does not affect the IVF results.
Dor
J
J
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
Shulman
A
A
Pariente
C
C
Levran
D
D
Bider
D
D
Menashe
Y
Y
Mashiach
S
S
D005260:Female; D005307:Fertilization in Vitro; D012739:Gonadal Steroid Hormones / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000502:physiology* / Q000627:therapeutic use; D006801:Humans; D009865:Oocytes; D010053:Ovary / Q000187:drug effects*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011446:Prospective Studies; D013048:Specimen Handling; D017329:Triptorelin Pamoate
D012739:Gonadal Steroid Hormones; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone