[Ovarian stimulation for in vitro fertilization using LHRH agonists: comparison of plasma and intra-follicular hormone profiles using "short" and "long" protocols].
Plasmatic estradiol (E2), progesterone (P) and LH were measured during the follicular phase of 343 cycles induced for in vitro fertilization (IVF) using a LHRH agonist in a "long protocol" (Group I) and 76 cycles in a "short protocol" (Group II). Moreover measurements in the plasma and follicular fluid (FF) of E2, P, LH, Delta-4-androstenedione (A), Testosterone (T) and prolactin (PRL) were performed on the day of oocyte retrieval (DO) in 46 women of the group I (111 FF) and 27 of the group II (67 FF). In the group I, plasma LH always remains below 3 mUl/ml, whatever the type of agonist (Buserelin or DTRP6-LHRH) and the type of stimulation (HMG or FSH) are used. On the other hand in the group II, mean plasma LH and P levels from D-5 to D-2 and those of FF LH, T and A on DO are significantly higher than in the group I. These changes are associated with a significant decrease of retrieved oocytes (5.8 versus 7.8 p less than 0.0001), pregnancy rate (15% versus 30%, p less than 0.01) and ongoing pregnancy rate (10% versus 22%, per oocyte retrieval, p less than 0.01). They suggest that the pituitary desensitization could be unsatisfactory with the short protocol use of agonist.
Antoine
J M
JM
Service de Gynécologie-Obstétrique, Hôpital Tenon, Paris.
Firmin
C
C
Alvarez
S
S
Cornet
D
D
Tibi
C
C
Mandelbaum
J
J
Plachot
M
M
Salat-Baroux
J
J
D000328:Adult; D000735:Androstenedione / Q000097:blood / Q000737:chemistry; D002064:Buserelin / Q000008:administration & dosage / Q000627:therapeutic use*; D002985:Clinical Protocols / Q000592:standards*; D004958:Estradiol / Q000097:blood / Q000737:chemistry; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood / Q000737:chemistry; D008186:Luteolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000097:blood / Q000737:chemistry; D011388:Prolactin / Q000097:blood / Q000737:chemistry; D012189:Retrospective Studies; D013739:Testosterone / Q000097:blood / Q000737:chemistry; D017329:Triptorelin Pamoate
D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D000735:Androstenedione; D011374:Progesterone; D004958:Estradiol; D011388:Prolactin; D007986:Luteinizing Hormone; D002064:Buserelin
Stimulation ovarienne pour fécondation in vitro utilisant les agonistes de la LHRH: comparison des profils hormonaux plasmatiques et intra-folliculaires des protocoles "courts" et "longs".