Serum and follicular fluid hormone levels during in vitro fertilization after short- or long-course treatment with a gonadotropin-releasing hormone agonist.
OBJECTIVE
To examine the impact of flare (short) vs. down-regulation (long) GnRH agonist (GnRH-a) on serum and follicular fluid (FF) LH and androgen concentrations in women undergoing IVF treatment cycles.


METHODS
Prospective observational study.


METHODS
IVF clinic.


METHODS
One hundred sixteen ovulatory subjects undergoing IVF.


METHODS
Fifty-eight ovulatory patients undergoing a down-regulation regimen matched with 58 undergoing the flare regimen as part of an IVF cycle.


METHODS
Serum concentrations of LH, FSH, Progesterone (P4), Androstenedione (A), T, and E(2) on the day of hCG administration were compared between the two groups. In addition, the FF P4, 17OHP4, A, T, and E(2) levels were compared in the two groups.


RESULTS
Serum LH was significantly higher with the flare regimen (15.2 +/- 1.14 IU/L, P<.05) when compared with results with the down-regulation protocol (9.5 +/- 0.77 IU/L). In addition, FF A was significantly higher in the flare protocol (57.3 +/- 13.3 ng/mL, P<.05) compared with in the down-regulation protocol (27 +/- 2.44 ng/mL). Serum and FF P4, 17OH P4, T, and E(2) were not statistically significantly different between the two groups.


CONCLUSIONS
Serum LH and FF A are significantly higher in the flare regimen in comparison with the down-regulation regimen. Circulating LH appears to play a role in determining FF A concentration.
Bo-Abbas
Y Y
YY
Reproductive Endocrine Unit, National Center for Infertility Research, Massachusetts General Hospital, Boston, USA.
Martin
K A
KA
Liberman
R F
RF
Cramer
D W
DW
Barbieri
R L
RL
D000328:Adult; D000735:Androstenedione / Q000032:analysis / Q000097:blood; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004958:Estradiol / Q000032:analysis / Q000097:blood; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro / Q000379:methods; D005640:Follicle Stimulating Hormone / Q000032:analysis* / Q000097:blood; D015571:Follicular Fluid / Q000737:chemistry* / Q000502:physiology; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D007986:Luteinizing Hormone / Q000032:analysis* / Q000097:blood; D008297:Male; D010060:Ovulation; D011247:Pregnancy; D011374:Progesterone / Q000032:analysis* / Q000097:blood; D011446:Prospective Studies; D013739:Testosterone / Q000032:analysis / Q000097:blood
D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D013739:Testosterone; D000735:Androstenedione; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide