Triggering of ovulation using a gonadotrophin-releasing hormone agonist does not prevent ovarian hyperstimulation syndrome.
A total of 24 women with primary or secondary infertility due to oligo- or anovulation, were treated with human menopausal gonadotrophin (HMG). In 48 cycles, we used a gonadotrophin-releasing hormone agonist (GnRHa) nasal spray (buserelin) to induce a pre-ovulatory endogenous luteinizing hormone (LH) surge. In 44 cycles, there was a rapid rise of the serum LH concentration within 8 h from the first administration of GnRHa. One patient with pituitary hypogonadotrophic amenorrhoea showed a weak or no response in four treatment cycles. Conception occurred in 10 cycles (pregnancy/cycle (P/C) index = 22.7%), four of which ended in a spontaneous abortion and six of which are ongoing pregnancies. In 27 cycles, there was an increased risk for ovarian hyperstimulation syndrome (OHSS), defined as more than three follicles > or = 18 mm in diameter and/or serum oestradiol > 1200 pg/ml. Three of these treatment cycles gave rise to the development of moderate OHSS in the absence of exogenously administered human chorionic gonadotrophin, two being conception cycles.
van der Meer
S
S
Department of Obstetrics, Gynaecology and Fertility, Middelheim Hospital, Antwerpen, Belgium.
Gerris
J
J
Joostens
M
M
Tas
B
B
D000281:Administration, Intranasal; D000328:Adult; D002064:Buserelin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007986:Luteinizing Hormone / Q000378:metabolism*; D008596:Menotropins / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D011966:Receptors, LHRH / Q000187:drug effects*; D012307:Risk Factors; D012636:Secretory Rate / Q000187:drug effects
D011966:Receptors, LHRH; D008596:Menotropins; D007986:Luteinizing Hormone; D002064:Buserelin