Abstract
The impact of gonadotropin releasing hormone agonist (GnRH-a) on the quality and quantity of oocytes harvested in in vitro fertilization—embryo transfer (IVF-ET) patients was studied by comparing the results for patients stimulated with gonadotropin alone and with gonadotropin plus GnRH-a. Adding GnRH-a significantly improved the viable pregnancies per transfer and reduced the spontaneous abortions, which seemed to improve oocyte quality. However, when oocyte quality was evaluated by the fertilization rate and the implantation and delivery rates per embryos transferred, there were no significant difference in the results, indicating that GnRH-a did not improve the oocyte quality. On the other hand, GnRH-a significantly increased the average number of oocytes harvested, fertilized, and transferred, and this increased number of oocytes transferred has been demonstrated to increase pregnancy and multiple-pregnancy rates. Multiple pregnancy with more embryos implanted would significantly reduce the abortion rate. Abortion rates decreased inversely to the number of embryos implanted. Our data strongly suggest that the efficacy of GnRH-a on IVF-ET patients was due more to the quantity increase than the quality of embryos transferred.
Similar content being viewed by others
References
Mar RP, Vargyas JM, Saito H, Gibbons WE, Berger T, Mishell DR Jr: Clinical applications of techniques used in human in vitro fertilization research. Am J Obstet Gynecol 1983;146:477
Neveu S, Hedon B, Bringer J, Chinchole MJ, Arnal F, Humeau C, Crostol P, Viala JL: Ovarian stimulation by a combination of a gonadotropin-releasing hormone agonist and gonadotropins for in vitro fertilization. Fertil Steril 1987;47:639
Meldrum DR, Wisot A, Hamilton F, Gutlay AL, Kempton W, Huynh D: Routine pituitary suppression with leuprolide before ovarian stimulation for oocyte retrieval. Fertil Steril 1989;51:455
Rutherford AJ, Subak-Sharpe RJ, Dawson KJ, Margara RA, Franks S, Winston RML: Improvement of in vitro fertilization after treatment with buserelin, an agonist of luteinizing hormone releasing hormone. Br Med J 1988;296:1765
Chetkowski RJ, Rode AR, Burruel V, Nass TE: The effect of pituitary suppression and the women's age on embryo viability and uterine receptivity. Fertil Steril 1991;56:1095
Porter RN, Smith W, Craft JL, Abdulwahid NA, Jacobs HS: Induction of ovulation for in vitro fertilization with buserelin and gonadotropins. Lancet 1984;2:1284
de Ziegler D, Cedars MI, Randle D, Lu JKH, Judd H, Meldrum DR: Suppression of the ovary using a gonadotropin releasing hormone agonist prior to stimulation for the retrieval. Fertil Steril 1987;48:807
Serafini P, Stone B, Kerin J, Batzofin J, Quinn P, Mar RP: An alternate approach to controlled ovarian hyperstimulation in “poor responders”: Pretreatment with a gonadotropin releasing hormone analog. Fertil Steril 1988;49:90
Palermo R, Amodeo G, Navot D, Rosenwaks Z, Cittadini E: Concomitant gonadotropin-releasing hormone agonist and menotropin treatment for the synchronized induction multiple follicles. Fertil Steril 1986;49:226
Fleming R, Coutts JRT: Induction of multiple follicular growth in normally menstruating women with endogenous gonadotropin suppression. Fertil Steril 1986;45:266
Wood C, McMaster R, Rennie G, Trounson A, Leeton J: Factors influencing pregnancy rates following in vitro fertilization and embryo transfer. Fertil Steril 1985;43:245
Edwards RG, Steptoe PC: Current status of in vitro fertilization and implantation of human embryos. Lancet 1983;2:1265
Rosenwaks Z, Muashar SJ, Acosta AA: Use of hMG and/or FSH for multiple follicle development. Clin Obstet Gynecol 1986;29:148
Veeck LL, Wortham JWE Jr, Witmyer J, Sandow BA, Acosta AA, Garcia JE, Jones GS, Jones HW Jr: Maturation and fertilization of morphologically immature human oocytes in a program of in vitro fertilization. Fertil Steril 1983;39:594
Jones HW Jr, Acosta AA, Wright GL Jr: A technique for the aspiration of oocytes from human ovarian follicles. Fertil Steril 1983;39:594
Jones HW Jr, Acosta AA, Garcia JE, Sandow BA, Veeck L: On the transfer of concepti from oocytes fertilized in vitro. Fertil Steril 1983;39:241
Liu H-C, Jones HW Jr, Rosenwaks Z: The efficiency of human reproduction after in vitro fertilization and embryo transfer. Fertil Steril 1988;49:649
Brzyski RG, Muasher SJ, Droesch K, Simonetti S, Jones GS, Rosenwaks Z: Follicular atresia associated with concurrent initiation of gonadotropin-releasing hormone agonist and follicle-stimulating hormone for oocyte recruitment. Fertil Steril 1988;50:917
Garcia JE, Padilla SL, Bayati J, Baramki T: Follicular phase gonadotropin-releasing hormone agonist and human gonadotropins: A better alternative for ovulation induction in in vitro fertilization. Fertil Steril 1990;53:302
Seifer DB, Lavy TG, Decherney AH: Early ovarian suppression with leuprolide acetate may be productive of IVF-ET success. 38th Annual Meeting of the Society for Gynecologic Investigation, 1991, abstr 157
Liu HC, Jones GS, Jones HW Jr, Rosenwaks Z: Mechanisms and factors of early pregnancy wastage in in vitro fertilization—embryo transfer patients. Fertil Steril 1988;50:95
Trounson AO: Factors controlling normal embryo development and implantation of human oocytes fertilized in vitro.In Fertilization of the Human Egg in Vitro, HM Beier, HR Lindner (eds). Berlin, Springer-Verlag, 1983, p 235
Meldrum DR, Tsao Z, Monroe SE, Braustein GD, Sladek J, Lu JKH, Vale W, Rivier J, Judd HL, Chang RJ: Stimulation of LH fragments with reduced bio-activity following GnRH agonist administration in women. J Clin Endocrinol Metab 1984;58:755
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Liu, HC., Lai, YM., Davis, O. et al. Improved pregnancy outcome with gonadotropin releasing hormone agonist (GnRH-a) stimulation is due to the improvement in oocyte quantity rather than quality. J Assist Reprod Genet 9, 338–344 (1992). https://doi.org/10.1007/BF01203956
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01203956