[Value of plasma progesterone (rapid assay) during ovarian stimulation for in vitro fertilization using LHRH agonists and hMG].
We have studied all the cycles (= 276) induced for in vitro fertilization using a LHRH agonist and the hMG (113 short protocols, 163 long protocols) from 01.90 to 07.90 to know the plasmatic profiles of the estradiol (E2), of the LH and specially of the progesterone (P) between J-7 and the day of the hCG (= J0). We observe in the short protocol an elevation (effect flare up) and afterwards a fall concomitant of the P and of the LH up to J-5, J-6 (effect of pituitary down regulation), in the short and long protocols a progressive elevation of J-3 up to J0 of the P parallel to E2, so that the LH remain stable or decrease. The LH of J0 is higher in short protocol than in long protocol (10.14 +/- 2.9 versus 4.72 +/- 1.3 Ul/l, p < 0.00001). We found the same progressive elevation of the P of J-3 up to J0 in pregnant and not pregnant patients. The surveillance of the P coupled to the E2 and to the follicular ultrasonography could help in the choice of the day of the hCG and avoid a post-maturity of oocyte. The consequences of the elevation of P In the morning of J0 have been study for P levels < 1 ng/ml (73 cases) and P > or = 1 ng/ml (203 cases) and afterwards for progressive elevation of P levels (1.5-2-2.5-3 ng/ml).(ABSTRACT TRUNCATED AT 250 WORDS)
Département de gynécologie, oncologie, gynécologique, sénologie, médecine de la reproduction, Hôpital Edouard-Herriot, Lyon.
D
D
Boulieu
L
L
Ayzac
M
M
Nanez
M
M
Karass
F
F
Payan
J F
JF
Guérin
C
C
Mathieu
M C
MC
Pinatel
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D002985:Clinical Protocols; D016903:Drug Monitoring; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011374:Progesterone / Q000097:blood*; D012189:Retrospective Studies
D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D002064:Buserelin
Intérêt de l'étude de la progestérone plasmatique (dosage rapide) au cours de la stimulation ovarienne pour fécondation in vitro utilisant les agonistes de LHRH et les hMG.