A randomized controlled study comparing the endocrine effects of pulsatile intravenous gonadotropin-releasing hormone after gonadotropin-releasing hormone agonist pretreatment versus clomiphene citrate in patients with polycystic ovary syndrome.
OBJECTIVE
To compare the endocrine changes in the follicular phase in infertile patients with polycystic ovary syndrome (PCOS) treated with either pulsatile IV GnRH after GnRH-agonist (GnRH-a) down-regulation or clomiphene citrate (CC).


METHODS
Subgroup analysis within a randomized, controlled, multicenter study.


METHODS
Women referred to the Infertility Clinic, Catharina Hospital Eindhoven, The Netherlands.


METHODS
Twenty-eight infertile patients with PCOS. INTERVENTIONs): Patients were randomly assigned to pulsatile IV GnRH (10-20 microgram/90 min) after GnRH-a down-regulation or CC (50-150 mg; cycle days 3-7). Patients were monitored on alternate days with ovarian sonography and serum concentrations of E(2), LH, and FSH. Serum P and sonography confirmed ovulation.


METHODS
Serum concentrations of E(2), LH, and FSH were assessed before treatment was started and after each ovarian sonography.


RESULTS
In ovulatory cycles, no statistically significant differences were observed during the follicular phase comparing serum concentrations of E(2), LH, and FSH between the treatments. However, a significant increase in LH occurred in the GnRH group.


CONCLUSIONS
No significant endocrine differences were observed between GnRH and CC treatment. However, there was a significant increase in the serum LH concentration during the follicular phase in the GnRH group. Increments of LH in the GnRH group may be due to recovery of endogenous LH secretion.
Timmerman-van Kessel
E C
EC
Catharina Hospital, Eindhoven, The Netherlands.
Cikot
R J
RJ
Dargel-Donkers
E J
EJ
Zwertbroek
W
W
van Dop
P A
PA
Schoot
D C
DC
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D004702:Endocrine Glands / Q000187:drug effects*; D004958:Estradiol / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy; D007275:Injections, Intravenous; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy*; D011374:Progesterone / Q000097:blood; D011673:Pulsatile Flow
D005300:Fertility Agents, Female; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone