[Combined use of goserelin acetate and human menopausal gonadotropin in the induction of follicular growth in a program of fertilization in vitro and embryo transfer].
OBJECTIVE
to investigate the efficacy of a gonadotropin-releasing hormone analogue (GN-RH-a) in combination with human menopausal menotropin (hMG) for in-vitro fertilization.


METHODS
30 infertile women aged 32 to 37 years received a combined treatment with a long-acting slow-releasing Gn-RH-a and hMG to perform ovarian stimulation in a program of in-vitro fertilization. Serum levels of Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), 17-beta-estradiol (E2), Progesterone (P), were evaluated and transvaginal ultrasonographic examinations were performed during the treatment to assess the ovarian volume, the mean number and diameter of growing follicles and the endometrial morphology and thickness. Oocyte retrieval was performed by transvaginal-ultrasound-guided approach, 24-36 hours after the administration of human chorionic gonadotropin (hCG).


RESULTS
our data suggest that the combined use of Gn-RH-a and exogenous gonadotropins is associated with a more uniform ovarian response and with the absence of premature LH discharge. Moreover, the Gn-RH-a as polymer implant provides a controlled delivery per day over a one-month period and avoids the inconvenience of a daily administration.


CONCLUSIONS
this kind of Gn-RH-a formulation, in in-vitro fertilization programs, appears very effective in inducing a reversible hypogonadic state, easy to manage and well tolerated by the patient. Its association with exogenous gonadotropins appears to be effective in increasing the success rate of good quality oocyte retrieval.
Beneventi
F
F
Clinica Ostetrica e Ginecologica, Università degli Studi di Pavia, Policlinico S. Matteo IRCCS.
Persiani
P
P
Filoni
G
G
Masanti
M L
ML
Ravagni Probizer
M F
MF
Polatti
F
F
Zara
C
C
D000328:Adult; D004359:Drug Therapy, Combination; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006062:Gonadotropins / Q000627:therapeutic use*; D017273:Goserelin / Q000627:therapeutic use*; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects* / Q000502:physiology*; D010062:Ovulation Induction; D013997:Time Factors
D006062:Gonadotropins; D017273:Goserelin
Uso combinato del Goserelin acetato e della gonadotropina umana menopausale nell'induzione della crescita follicolare in un programma di fertilizzazione in vitro e embrio-transfer.