title: Dose of GnRH agonist (nafarelin acetate) affects intrafollicular PAPP-A expression in controlled ovarian hyperstimulation cycle.
abstract: OBJECTIVE
  To determine the effect of dose of GnRH agonist on the follicular environment in controlled ovarian hyperstimulation (COH) cycles.
  
  
  METHODS
  Twenty-eight IVF patients with normal ovarian function were divided into three groups: group I received GnRHa (nafarelin acetate/Synarel) intranasally at 200 microg daily, group II received 400 microg daily until hCG injection, and group III was given 400 microg daily before the initiation of ovarian stimulation, then 200 microg daily before the day of hCG injection. Serum estradiol, progesterone, and leptin levels were measured on the day of hCG injection. After aspiration, expression of pregnancy-associated alpha-plasma protein (PAPP)-A in the follicular fluid of dominant follicles (>20 mm) was determined by Western blot analysis.
  
  
  RESULTS
  No significant difference was noted in serum estradiol, progesterone, and leptin levels. But intrafollicular PAPP-A expression was significantly higher in group II compared to other groups (P<0.05).
  
  
  CONCLUSIONS
  The dose of GnRHa may have an impact on the intrafollicular environment of dominant follicles in COH cycles.
authors.affiliation: Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong Kangnam-Ku, Seoul 135-710, South Korea.
authors.forename: JiHyun
authors.initials: J
authors.lastname: Suh
authors.forename: EunYoung
authors.initials: E
authors.lastname: Lee
authors.forename: SeongSoo
authors.initials: S
authors.lastname: Hwang
authors.forename: Sarah
authors.initials: S
authors.lastname: Yoon
authors.forename: Byung Koo
authors.initials: BK
authors.lastname: Yoon
authors.forename: DukSoo
authors.initials: D
authors.lastname: Bae
authors.forename: DooSeok
authors.initials: D
authors.lastname: Choi
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D015153:Blotting, Western; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004958:Estradiol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female; D020738:Leptin / Q000097:blood; D008597:Menstrual Cycle / Q000187:drug effects*; D017274:Nafarelin / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011266:Pregnancy-Associated Plasma Protein-A / Q000032:analysis*; D011336:Probability; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D011863:Radioimmunoassay; D018570:Risk Assessment; D018709:Statistics, Nonparametric
chemical_list: D020738:Leptin; D017274:Nafarelin; D011374:Progesterone; D004958:Estradiol; D011266:Pregnancy-Associated Plasma Protein-A