Gonadotrophin-releasing hormone-antagonist luteolysis during the preceding mid-luteal phase is a feasible protocol in ovarian hyperstimulation before in vitro fertilization.
BACKGROUND
The aims of this study were to investigate whether a high dose of gonadotrophin-releasing hormone antagonist during the preceding luteal phase yields satisfactory luteolysis and downregulation prior to ovarian hyperstimulation in an in vitro fertilization program.


METHODS
The treatment protocol was designed as a prospective pilot study in IVF units at two university hospitals. Fifty-one patients with documented poor or normal response to ovarian stimulation underwent 57 treatment cycles. Treatment consisted of 3 mg gonadotrophin-releasing hormone antagonist (cetrorelix) given during the preceding mid-luteal phase as gonadotrophin-releasing hormone-receptor inhibition before ovarian stimulation with follicle-stimulating hormone.


RESULTS
All women experienced menstrual bleeding within 2-3 days after the injection of 3 mg cetrorelix. Follicle hormone stimulation could subsequently commence in all cycles. All but three patients developed growing follicles and underwent oocyte retrieval. Seventy-five percent of started cycles reached transfer of one or two good-quality embryos.


CONCLUSIONS
A single high-dose gonadotrophin-releasing hormone antagonist given during the preceding luteal phase presents a new and feasible protocol to initiate controlled ovarian hyperstimulation in an in vitro fertilization program.
Fridén
Barbro E
BE
IVF Unit, Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital, Stockholm, Sweden. barbro.friden@telia.com
Nilsson
Lars
L
D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004624:Embryo Transfer; D005240:Feasibility Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006801:Humans; D008183:Luteal Phase / Q000187:drug effects / Q000502:physiology; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D010062:Ovulation Induction / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D007987:Gonadotropin-Releasing Hormone; C062876:cetrorelix