The effects of gonadotropin-releasing hormone agonist on androstenedione production and follicular development during controlled ovarian hyperstimulation.
OBJECTIVE
We performed a prospective randomized study to assess the effects of a GnRH agonist (GnRH-a) on follicular development and steroidogenesis during controlled ovarian hyperstimulation (COH).


METHODS
Patients undergoing in vitro fertilization (IVF) for tubal infertility received human menopausal gonadotropin (hMG) stimulation with or without the GnRH-a, buserelin, beginning in the midluteal phase of the prior cycle. We analyzed serum hormone levels, follicular development, and outcome of IVF.


RESULTS
The mean number of retrieved oocytes was significantly greater, and the implantation rate per embryo was significantly higher, in the GnRH-a/hMG group (n = 101) than in the hMG-only group (n = 97). The concentration of androstenedione (A) and the A/estradiol ratio in the serum were significantly lower in the GnRH-a treatment group throughout the follicular phase.


CONCLUSIONS
The concomitant use of GnRH-a during COH prevents atretic change of the follicles and enhances follicular development by reducing androgen accumulation, resulting in a higher developmental competence of the oocytes.
Department of Obstetrics and Gynecology, Tokyo Dental College, Chiba, Japan.
K
K
Akaboshi
T
T
Oda
J
J
Yoshida
S
S
Kohriyama
T
T
Miyazaki
Y
Y
Yoshimura
D000328:Adult; D000735:Androstenedione / Q000096:biosynthesis* / Q000097:blood; D002064:Buserelin / Q000494:pharmacology* / Q000627:therapeutic use; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology* / Q000627:therapeutic use; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D005496:Follicular Atresia / Q000187:drug effects / Q000502:physiology; D006062:Gonadotropins / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology*; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies
D005300:Fertility Agents, Female; D006062:Gonadotropins; D000735:Androstenedione; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D002064:Buserelin