Comparison of FSH flare with and without pretreatment with oral contraceptive pills in poor responders undergoing in vitro fertilization.
OBJECTIVE
To compare FSH, LH, estrogen, and P flare response following 1 mg lupron injection in poor responders with or without pretreatment with oral contraceptive pills (OCPs).


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Poor responders undergoing IVF flare protocol from October 2002 to November 2003.


METHODS
Patients were divided into group A, who received OCPs before IVF cycle (n = 12), and group B, who did not (n = 7). One milligram Lupron was injected SC after measuring day 2 serum FSH, LH, estrogen, and P. After 24 hours, serum hormones were measured before lupron administration.


METHODS
Serum FSH, LH, estrogen, and P before and after 1 mg lupron


RESULTS
Basal FSH was similar in both groups (8.6 +/- 4.5 vs. 9.6 +/- 2.9 mIU/mL). Group A patients had significantly lower day 2 FSH (3.6 +/- 3.6 vs. 10.1 +/- 4.2 mIU/mL; P<.05). After lupron, although both groups had a significant rise in FSH and LH, mean LH rise in group B was 39.5 +/- 31 mIU/mL versus 11.3 +/- 4.6 mIU/mL in group A (P<.05).


CONCLUSIONS
Pretreatment with OCPs in GnRH agonist flare protocol suppresses pre-Lupron FSH but does not blunt FSH flare. It blunts LH flare, which may be beneficial.
Keltz
Martin D
MD
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, St. Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10019, USA.
Gera
Puja S
PS
Skorupski
Josh
J
Stein
Daniel E
DE
D000328:Adult; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy*; D016729:Leuprolide / Q000008:administration & dosage*; D007986:Luteinizing Hormone / Q000097:blood; D017211:Treatment Failure
D003276:Contraceptives, Oral; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D016729:Leuprolide