Aberrant estradiol flare despite gonadotropin-releasing hormone-agonist-induced suppression is associated with impaired implantation.
Our results confirm the previous report that rapid suppression by GnRH-a is favorable relative to delayed suppression (1). They further indicate that the pattern of E2 production during GnRH-a-induced ovarian suppression may be predictive of cycle outcome. We suggest that imperfect pituitary suppression of bioactive LH as indicated by an aberrant rise in E2 during GnRH-a down-regulation may compromise oocyte quality and ultimately impair implantation. Further study of follicular phase E2 response to GnRH-a suppression may provide a prognostic marker for implantation.
Penzias
A S
AS
Department of Obstetrics and Gynecology, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts 02111.
Lee
G
G
Seifer
D B
DB
Shamma
F N
FN
DeCherney
A H
AH
Reindollar
R H
RH
Jones
E E
EE
D010064:Embryo Implantation; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D016729:Leuprolide / Q000494:pharmacology*; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000494:pharmacology; D017274:Nafarelin / Q000494:pharmacology*; D010053:Ovary / Q000187:drug effects*; D010902:Pituitary Gland / Q000187:drug effects*; D013997:Time Factors; D016896:Treatment Outcome
D017274:Nafarelin; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide