title: Sequential danazol/leuprolide acetate therapy for ovarian suppression in an in vitro fertilization patient unresponsive to leuprolide acetate.
abstract: We report a case of pituitary-ovarian suppression obtained with sequential danazol/leuprolide acetate administration in a patient undergoing in vitro fertilization and unresponsive to leuprolide acetate alone and sequential oral contraceptive-leuprolide acetate therapy. Leuprolide acetate (1 mg daily subcutaneously) was administered after 5 weeks of danazol treatment (800 mg daily) while the latter was maintained for 1 additional week. Ovarian activity was assessed by transvaginal ultrasonography and serum estradiol determination. After 5 weeks of danazol therapy, ovarian arrest was obtained despite the fact that gonadotropin serum levels did not change relative to basal values. Leuprolide acetate injection for 14 days was associated with a decrease in serum concentrations of follicle-stimulating hormone and luteinizing hormone and a further decrease of the estradiol level. We conclude that sequential danazol/leuprolide acetate therapy is a useful alternative for obtaining ovarian arrest in patients unresponsive to leuprolide acetate alone.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Barcelona, Hospital Clínic i Provincial, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Balasch
authors.forename: F
authors.initials: F
authors.lastname: Fábregues
authors.forename: M
authors.initials: M
authors.lastname: Creus
authors.forename: J A
authors.initials: JA
authors.lastname: Vanrell
mesh_terms: D000328:Adult; D003276:Contraceptives, Oral / Q000008:administration & dosage; D003613:Danazol / Q000008:administration & dosage* / Q000627:therapeutic use; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D004965:Estrogen Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D004997:Ethinyl Estradiol / Q000008:administration & dosage; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D016729:Leuprolide / Q000008:administration & dosage* / Q000627:therapeutic use; D016912:Levonorgestrel / Q000008:administration & dosage; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction; D014463:Ultrasonography
chemical_list: D003276:Contraceptives, Oral; D004965:Estrogen Antagonists; D004997:Ethinyl Estradiol; D004958:Estradiol; D016912:Levonorgestrel; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide; D003613:Danazol