title: 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.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Antoine Béclère, Clamart, France. renato.fanchin@abc.ap-hop-paris.fr
authors.forename: Renato
authors.initials: R
authors.lastname: Fanchin
authors.forename: Altina
authors.initials: A
authors.lastname: Castelo Branco
authors.forename: Isaac Jacques
authors.initials: IJ
authors.lastname: Kadoch
authors.forename: Ghada
authors.initials: G
authors.lastname: Hosny
authors.forename: Mira
authors.initials: M
authors.lastname: Bagirova
authors.forename: René
authors.initials: R
authors.lastname: Frydman
mesh_terms: 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
chemical_list: D006727:Hormone Antagonists; D006728:Hormones; D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix