Premature luteinization during gonadotropin-releasing hormone antagonist cycles and its relationship with in vitro fertilization outcome.
OBJECTIVE
To determine the prevalence and the effect of premature luteinization in GnRH antagonist IVF-ET cycles.


METHODS
Prospective observational study.


METHODS
In vitro fertilization-embryo transfer (IVF-ET) program at the Instituto Valenciano de Infertilidad.


METHODS
Eighty-one infertile patients undergoing controlled ovarian hyperstimulation with gonadotropins and GnRH antagonist for IVF-ET.


METHODS
Gonadotropin-releasing hormone (GnRH) antagonist was administered from stimulation day 6. Serum P, E(2), and LH were determined on the day of hCG administration.


METHODS
Cycles were grouped according to serum P level on the day of hCG administration (<1.2 ng/mL or > or =1.2 ng/mL). Clinical pregnancy and implantation rates were determined.


RESULTS
The incidence of premature luteinization was 38.3%. Total recombinant FSH dose and stimulation days differed significantly between the groups. Pregnancy rate (25.8% vs. 54.0%) and implantation rate (13.8% vs. 32.0%) were significantly lower in the premature luteinization group.


CONCLUSIONS
Premature luteinization during GnRH antagonist IVF-ET cycles is a frequent event that is associated with lower pregnancy and implantation rates. Progesterone elevations are not related to serum LH levels and may reflect the mature granulosa cell response to high FSH exposure.
Bosch
Ernesto
E
Instituto Valenciano de Infertilidad, Valencia, Spain.
Valencia
Iván
I
Escudero
Ernesto
E
Crespo
Juana
J
Simón
Carlos
C
Remohí
José
J
Pellicer
Antonio
A
D000293:Adolescent; D000328:Adult; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D043373:Follicle Stimulating Hormone, Human / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D006801:Humans; D034461:Luteinization / Q000187:drug effects / Q000502:physiology*; D015999:Multivariate Analysis; D009865:Oocytes / Q000166:cytology / Q000187:drug effects; D006080:Ovarian Follicle / Q000166:cytology* / Q000187:drug effects; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods
D043373:Follicle Stimulating Hormone, Human; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; C062876:cetrorelix