The gonadotropin-releasing hormone agonist stimulation test--a sensitive predictor of performance in the flare-up in vitro fertilization cycle.
OBJECTIVE
To evaluate the initial versus early pattern of estradiol (E2) change after administration of a gonadotropin-releasing hormone agonist (GnRH-a), i.e., the GnRH-a stimulation test versus E2 pattern, respectively, as predictors of ovarian response and pregnancy in in vitro fertilization (IVF) patients stimulated with a flare-up protocol.


METHODS
Prospective study in a consecutive group of patients.


METHODS
Tertiary care, institutional setting.


METHODS
Two hundred twenty-eight patients entered and completed the study. The only patients excluded from study were those anticipated to have polycystic ovarian disease, those with a single ovary, or those with an ovarian cyst(s).


METHODS
Patients were stimulated with a GnRH-a flare-up protocol beginning on menstrual day 2.


RESULTS
Evaluation of the GnRH-a stimulation test and the E2 pattern as predictors of the number of mature oocytes retrieved and pregnancy.


RESULTS
The GnRH-a stimulation test but not the E2 pattern was predictive of the number of mature oocytes retrieved (r = 0.53, P less than 1 X 10(-5) and pregnancy (chi 2 = 8.5, P = 0.04). The E2 pattern was predictive of the duration and number of ampules of gonadotropin required for stimulation.


CONCLUSIONS
The GnRH-a stimulation test is a sensitive predictor of performance in the flare-up IVF cycle.
Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk.
K L
KL
Winslow
J P
JP
Toner
R G
RG
Brzyski
S C
SC
Oehninger
A A
AA
Acosta
S J
SJ
Muasher
D000328:Adult; D002452:Cell Count; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D016729:Leuprolide; D008596:Menotropins / Q000627:therapeutic use; D009865:Oocytes / Q000166:cytology; D010053:Ovary / Q000502:physiology; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies
D004958:Estradiol; D008596:Menotropins; D005640:Follicle Stimulating Hormone; D016729:Leuprolide