Skip to main content

Ovarian stimulation for in vitro fertilization using pure follicle-stimulating hormone with and without gonadotropin-releasing hormone agonist in high-responder patients.

Publication ,  Journal Article
Edelstein, MC; Brzyski, RG; Jones, GS; Oehninger, S; Sieg, SM; Muasher, SJ
Published in: J In Vitro Fert Embryo Transf
June 1990

There is a distinct pattern of response to gonadotropin stimulation in some patients marked by high peak estradiol (E2) levels, multifollicular ovarian response, and elevated basal luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios. We reviewed the stimulation profiles of five such high-responder patients who failed to conceive during in vitro fertilization with ovarian stimulation using pure FSH. All patients had baseline LH/FSH greater than 1.5 and peak E2 greater than 800 pg/ml. One cycle was canceled prior to hCG administration because of marked ovarian response (E2 greater than 2500 pg/ml, multiple small follicles). In a subsequent cycle, all patients were pretreated with the gonadotropin releasing-hormone agonist (GnRHa) leuprolide acetate for 10-14 days prior to initiation of FSH for ovarian stimulation. Leuprolide was continued until the day of hCG administration. During cycles using GnRHa, there was a statistically significant decrease (P less than 0.05) in serum FSH on day 3 (less than 5 vs 8.3 mIU/ml), serum E2 on day 3 (14.6 vs 34.6 pg/ml), and peak serum E2 (1197.6 vs 1923.0 pg/ml). Patients during cycles with GnRHa had a greater number of preovulatory (8.6 vs 3.0) and total (12.4 vs 6.0) oocytes retrieved (P less than 0.05). The fertilization rate of preovulatory oocytes was also higher during cycles using GnRHa (83 vs 64%). Two pregnancies occurred in the cycles pretreated with GnRHa. These preliminary data indicate that in high-responder patients, a combination of GnRHa and pure FSH results in lower E2 levels during the stimulation cycle and a greater number of total and mature oocytes retrieved and fertilized.

Duke Scholars

Published In

J In Vitro Fert Embryo Transf

DOI

ISSN

0740-7769

Publication Date

June 1990

Volume

7

Issue

3

Start / End Page

172 / 176

Location

United States

Related Subject Headings

  • Pituitary Gland
  • Ovulation Induction
  • Ovary
  • Luteinizing Hormone
  • Leuprolide
  • Humans
  • Hormones
  • Gonadotropin-Releasing Hormone
  • Follicle Stimulating Hormone
  • Fertilization in Vitro
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Edelstein, M. C., Brzyski, R. G., Jones, G. S., Oehninger, S., Sieg, S. M., & Muasher, S. J. (1990). Ovarian stimulation for in vitro fertilization using pure follicle-stimulating hormone with and without gonadotropin-releasing hormone agonist in high-responder patients. J In Vitro Fert Embryo Transf, 7(3), 172–176. https://doi.org/10.1007/BF01135684
Edelstein, M. C., R. G. Brzyski, G. S. Jones, S. Oehninger, S. M. Sieg, and S. J. Muasher. “Ovarian stimulation for in vitro fertilization using pure follicle-stimulating hormone with and without gonadotropin-releasing hormone agonist in high-responder patients.J In Vitro Fert Embryo Transf 7, no. 3 (June 1990): 172–76. https://doi.org/10.1007/BF01135684.
Edelstein MC, Brzyski RG, Jones GS, Oehninger S, Sieg SM, Muasher SJ. Ovarian stimulation for in vitro fertilization using pure follicle-stimulating hormone with and without gonadotropin-releasing hormone agonist in high-responder patients. J In Vitro Fert Embryo Transf. 1990 Jun;7(3):172–6.
Edelstein, M. C., et al. “Ovarian stimulation for in vitro fertilization using pure follicle-stimulating hormone with and without gonadotropin-releasing hormone agonist in high-responder patients.J In Vitro Fert Embryo Transf, vol. 7, no. 3, June 1990, pp. 172–76. Pubmed, doi:10.1007/BF01135684.
Edelstein MC, Brzyski RG, Jones GS, Oehninger S, Sieg SM, Muasher SJ. Ovarian stimulation for in vitro fertilization using pure follicle-stimulating hormone with and without gonadotropin-releasing hormone agonist in high-responder patients. J In Vitro Fert Embryo Transf. 1990 Jun;7(3):172–176.

Published In

J In Vitro Fert Embryo Transf

DOI

ISSN

0740-7769

Publication Date

June 1990

Volume

7

Issue

3

Start / End Page

172 / 176

Location

United States

Related Subject Headings

  • Pituitary Gland
  • Ovulation Induction
  • Ovary
  • Luteinizing Hormone
  • Leuprolide
  • Humans
  • Hormones
  • Gonadotropin-Releasing Hormone
  • Follicle Stimulating Hormone
  • Fertilization in Vitro