GnRH antagonists in normal- responder patients.
To review the use of GnRH antagonists in normal-responding patients who are undergoing infertility treatment. Review article and case studies.For the normal-responding patient, GnRH antagonist protocols provide equivalent outcomes as GnRH agonist protocols, with the added patient benefit of significantly fewer treatment/injection days. In addition, a decrease or plateau in E(2) on the day after initiation of the GnRH antagonist has no prognostic significance in IVF outcome.For normal-responding patients, a GnRH antagonist can be used in a flexible fashion to achieve high success rates. The lack of correlation between E(2) patterns on the day after initiation of a GnRH antagonist and IVF outcomes supports the concept that no intervention (such as LH add-back) is necessary to guard against an early decrease or plateau during stimulation with recombinant FSH and a GnRH antagonist. Clinicians must consider ovarian physiology and the mechanism of GnRH antagonist action in patient management.
Shapiro
Daniel B
DB
Reproductive Biology Associates, Atlanta, Georgia 30342, USA. drshap@aol.com
D004624:Embryo Transfer / Q000706:statistics & numerical data; D005260:Female; D005306:Fertilization / Q000187:drug effects; D005307:Fertilization in Vitro / Q000379:methods; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D008597:Menstrual Cycle / Q000187:drug effects / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012016:Reference Values; D012189:Retrospective Studies
D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone