title: Exogenous gonadotropin stimulation is associated with increases in serum androgen levels in in-vitro fertilization-embryo transfer cycles.
abstract: OBJECTIVE
  To examine serum androgen profiles in women undergoing ovarian stimulation with exogenous gonadotropins in the setting of IVF-ET.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  University hospital IVF-ET program.
  
  
  METHODS
  Seventeen ovulatory women undergoing IVF-ET for endometriosis, male factor infertility, or tubal disease.
  
  
  METHODS
  A standard long protocol of GnRH agonist (GnRH-a) pretreatment (1 mg of leuprolide acetate SC for 10 days) was administered before ovulation induction with a urinary gonadotropin preparation.
  
  
  METHODS
  After 10 days of GnRH-a treatment and on the day of hCG administration, serum concentrations of LH, T, androstenedione (A), sex hormone-binding globulin (SHBG), and DHEAS; the free androgen index (T/SHBG); and the number of follicles, oocytes, and embryos were assessed.
  
  
  RESULTS
  Serum samples after 10 days of GnRH-a treatment showed incomplete LH suppression. While continuing the agonist during ovarian stimulation, LH values were suppressed further. However, serum T and A concentrations and the free androgen index showed a significant increase (samples drawn just before hCG administration). Serum T levels after 10 days of GnRH-a (before the administration of exogenous gonadotropins) were correlated negatively with the subsequent number of embryos.
  
  
  CONCLUSIONS
  Serum LH suppression with a conventional regimen of GnRH-a is incomplete in this heterogeneous group of ovulatory women. Exogenous gonadotropin stimulation results in a marked increase in ovarian androgen secretion.
authors.affiliation: Reproductive Endocrine Unit, Massachusetts General Hospital, Boston.
authors.forename: K A
authors.initials: KA
authors.lastname: Martin
authors.forename: M D
authors.initials: MD
authors.lastname: Hornstein
authors.forename: A E
authors.initials: AE
authors.lastname: Taylor
authors.forename: J E
authors.initials: JE
authors.lastname: Hall
authors.forename: R L
authors.initials: RL
authors.lastname: Barbieri
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D012739:Gonadal Steroid Hormones / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives*; D006062:Gonadotropins / Q000097:blood*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000728:Androgens; D012739:Gonadal Steroid Hormones; D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide