[Continuous subcutaneous infusion of GnRH agonist: effective dosage in the treatment of endometriosis and its influence on the ovarian response to human menopausal gonadotropin].
This study was designed to compare the clinical and hormonal efficacy of the treatment for endometriosis using continuous infusion of three different doses of GnRH agonist (A). In addition, we examined the ovarian responsiveness to human menopausal gonadotropin (hMG) administration during GnRH-A treatment. Thirteen endometriosis patients were divided into 3 groups and given different doses. GnRH-A (Buserelin) was infused continuously through the subcutaneous route at rates of 200 micrograms (Group I; n = 5), 100 micrograms (Group II, n = 4) and 10 micrograms (Group III; n = 4) per day for 24 weeks. After the start of treatment, serum estradiol (E2) was suppressed to the menopausal range within 2 weeks and thereafter maintained this range until 24 weeks in each group. The LH and FSH response to a GnRH Challenge test was completely abolished within 2 weeks in 3 groups. Although serum FSH decreased to below the pretreatment value within a week, the FSH level was significantly lower in groups I and II than in group III until 8 weeks. No difference in the LH level during the treatment was seen among the 3 groups. After completion of the 24 weeks' treatment, FSH increased rapidly, and ovulation returned within 4 to 6 weeks in each group. Pregnancy was achieved in two patients in group I, one patient in group II and one patient in group III during cycles 2 and 5. Serum E2 increased to 200-300 pg/ml in 3 out of 7 patients treated with hMG during GnRH-A infusion, whereas no increase in E2 was seen in the remaining 4 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Masaoka
K
K
Department of Obstetrics and Gynecology, Dokkyo University School of Medicine, Tochigi.
Kitazawa
M
M
Watanabe
H
H
Kumasaka
T
T
D000328:Adult; D002064:Buserelin / Q000008:administration & dosage* / Q000627:therapeutic use; D004347:Drug Interactions; D004715:Endometriosis / Q000097:blood / Q000188:drug therapy*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007263:Infusions, Parenteral; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000008:administration & dosage / Q000627:therapeutic use*; D010053:Ovary / Q000187:drug effects*; D010060:Ovulation / Q000187:drug effects
D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002064:Buserelin