Combined clomiphene citrate (CC) and human menopausal gonadotropins (hMG) in a fixed schedule for follicular recruitment during in vitro fertilization: effects on premature luteinizing hormone (LH) surges.
Recognizing the association between plasma progesterone (P) and an imminent LH surge, we investigated the frequency of P elevation in our stimulation protocol (clomiphene citrate-human menopausal gonadotropins). P was measured retrospectively on the day before, the day of, and the day after human chorionic gonadotropin hCG administration. The means +/- 2 standard deviations for P were as follows: day before hCG, 0.58 +/- 0.86; day of hCG, 0.64 +/- 0.56; and day after hCG, 1.47 +/- 1.22. Seven patients (8%) had P levels greater than 2 SD above the mean. Significant P elevations prior to hCG are infrequent with this protocol, and in the few patients with raised P a trend toward lowered fertilization was noted. The low incidence of P elevation may be secondary to the administration of hCG in a timely manner on the sixth day of estradiol (E2) rise.
Blankstein
J
J
Department of Gynecology, Cleveland Clinic Foundation, Ohio 44106.
Collins
R L
RL
Easley
K A
KA
Gupta
M K
MK
Quigley
M M
MM
D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000494:pharmacology; D002996:Clomiphene / Q000008:administration & dosage / Q000494:pharmacology*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility; D005307:Fertilization in Vitro; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D008596:Menotropins / Q000008:administration & dosage / Q000494:pharmacology*; D008991:Monitoring, Physiologic; D009865:Oocytes / Q000502:physiology; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology; D011374:Progesterone / Q000097:blood; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D002996:Clomiphene; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone