Lower levels of inhibin A and pro-alphaC during the luteal phase after triggering oocyte maturation with a gonadotropin-releasing hormone agonist versus human chorionic gonadotropin.
OBJECTIVE
To investigate the effect of triggering oocyte maturation with GnRH agonist on corpus luteum function by measuring luteal phase levels of inhibin A and pro-alphaC.


METHODS
Prospective randomized trial.


METHODS
In vitro fertilization (IVF) program at a university hospital.


METHODS
Infertile women undergoing IVF-ET treatment.


METHODS
Controlled ovarian hyperstimulation with FSH and GnRH antagonist, triggering of final oocyte maturation with either hCG (n = 8) or GnRH agonist (n = 8), IVF-ET, and collection of blood samples every 2-3 days during the luteal phase.


RESULTS
Luteal phase serum levels of inhibin A and pro-alphaC, P, and E(2).


RESULTS
Levels of inhibin A, pro-alphaC, estrogen, and P were significantly lower from day 4 to day 14 after triggering final oocyte maturation by GnRH agonist compared with hCG. Maximal luteal serum inhibin A and pro-alphaC levels were 91.5 +/- 23.6 and 184.1 +/- 23.5 pg/mL in the GnRH agonist-treated women compared with 464.7 +/- 209.1 and 7,351.6 +/- 934.3 pg/mL in women treated with hCG.


CONCLUSIONS
Triggering final oocyte maturation with GnRH agonist instead of hCG in IVF cycles dramatically decreases luteal levels of inhibins, reflecting significant inhibition of the corpus luteum function. This effect may explain, at least in part, the mechanism of ovarian hyperstimulation syndrome prevention by the use of GnRH agonist.
Department of Obstetrics and Gynecology, Rambam Medical Center, Haifa, Israel.
Ori
O
Nevo
Talia
T
Eldar-Geva
Shahar
S
Kol
Joseph
J
Itskovitz-Eldor
D000328:Adult; D006063:Chorionic Gonadotropin / Q000494:pharmacology*; D004958:Estradiol / Q000097:blood; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors; D006801:Humans; D007265:Inhibins / Q000097:blood*; D016729:Leuprolide / Q000494:pharmacology; D008183:Luteal Phase / Q000097:blood*; D009865:Oocytes / Q000187:drug effects* / Q000502:physiology; D010053:Ovary / Q000033:anatomy & histology; D011374:Progesterone / Q000097:blood; D011498:Protein Precursors / Q000097:blood*; D017329:Triptorelin Pamoate / Q000494:pharmacology
D006063:Chorionic Gonadotropin; D011498:Protein Precursors; C422362:inhibin A; C095971:inhibin-alpha subunit precursor; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone; D004958:Estradiol; D007265:Inhibins; D016729:Leuprolide