Comparison of hCG versus GnRH analog for releasing oocytes following ultra low-dose gonadotropin stimulation.
Previous data have suggested there is a higher incidence of luteinized unruptured follicle (LUF) syndrome (defined as failure to release any oocyte as determined by sonography) in gonadotropin-treated patients following human chorionic gonadotropin (hCG) versus the gonadotropin releasing hormone agonist (GnRH-a) leuprolide acetate. The present study was designed to determine if an ultra low-dose gonadotropin regimen, designed not to raise the serum estradiol level much above normal for non-stimulated cycles, might result in a decrease in LUF following hCG treatment, and even reduce the rate to that seen following leuprolide acetate. The hypothesis tested was that the higher estradiol levels might suppress the pre-ovulatory follicle stimulating hormone (FSH) surge which, in turn, would inhibit plasmin production, thus preventing detachment of the oocyte from the follicle. The data did show a reduced rate of LUF incidence with either hCG or leuprolide acetate in ultra low-dose human menopausal gonadotropin-(hMG-) treated patients compared to data from previous studies with conventional hMG/hCG therapy. Pregnancy rates were also similar following hCG or leuprolide acetate for release in low-dose hMG-treated patients. Preliminary data show that leuprolide acetate is superior to hCG for causing oocyte release when stimulation is with low-dose purified FSH, and possibly also that low-dose hMG is superior to low-dose purified FSH for producing superior pregnancy rates.
Check
J H
JH
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden.
Vetter
B H
BH
Weiss
W
W
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008183:Luteal Phase / Q000187:drug effects; D007986:Luteinizing Hormone / Q000097:blood; D008596:Menotropins / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy / Q000187:drug effects; D016649:Primary Ovarian Insufficiency / Q000188:drug therapy*; D011374:Progesterone / Q000097:blood
D006063:Chorionic Gonadotropin; D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide