Premenstrual administration of gonadotropin-releasing hormone antagonist coordinates early antral follicle sizes and sets up the basis for an innovative concept of controlled ovarian hyperstimulation.
OBJECTIVE
To investigate whether premenstrual administration of a GnRH antagonist coordinates early antral follicle sizes during the subsequent follicular phase.


METHODS
Prospective, longitudinal study.


METHODS
University Hospital in France


METHODS
Twenty-five women, 50 cycles.


METHODS
On cycle day 2 (control/day 2), women underwent measurements of early antral follicles by ultrasound and serum FSH and ovarian hormones. On day 25, they received a single cetrorelix acetate administration, 3 mg. On the subsequent day 2 (premenstrual GnRH antagonist/day 2), participants were re-evaluated as on control/day 2.


METHODS
Magnitude of follicular size discrepancies.


RESULTS
Follicular diameters (4.1 +/- 0.9 vs. 5.5 +/- 1.0 mm) and follicle-to-follicle size differences decreased on premenstrual GnRH antagonist/day 2 as compared with control/day 2. Consistently, FSH (4.5 +/- 1.9 vs. 6.7 +/- 2.4 mIU/mL), E(2) (23 +/- 13 vs. 46 +/- 26 pg/mL), and inhibin B (52 +/- 30 vs. 76 +/- 33 pg/mL) were lower on GnRH antagonist/day 2 than on control/day 2.


CONCLUSIONS
Premenstrual GnRH antagonist administration reduces diameters and size disparities of early antral follicles on day 2, likely through the prevention of luteal FSH elevation and early follicular development. This simple, original approach may be used to coordinate multifollicular development in controlled ovarian hyperstimulation.
Fanchin
Renato
R
Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart, France. renato.fanchin@abc.ap-hop-paris.fr
Castelo Branco
Altina
A
Kadoch
Isaac Jacques
IJ
Hosny
Ghada
G
Bagirova
Mira
M
Frydman
René
R
D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006728:Hormones / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008183:Luteal Phase; D006080:Ovarian Follicle / Q000000981:diagnostic imaging* / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011446:Prospective Studies; D014463:Ultrasonography
D006727:Hormone Antagonists; D006728:Hormones; D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix