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Erschienen in: Journal of Assisted Reproduction and Genetics 4/2008

01.04.2008 | Assisted Reproduction

The decrease of serum luteinizing hormone level by a gonadotropin-releasing hormone antagonist following the mild IVF stimulation protocol for IVF and its clinical outcome

verfasst von: Atsushi Yanaihara, Takeshi Yorimitsu, Hiroshi Motoyama, Motohiro Ohara, Toshihiro Kawamura

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 4/2008

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Abstract

Purpose

While performing the mild ovarian stimulation protocol with a GnRH antagonist, the pregnancy rate was compared between the groups, which were divided by the degree that the luteinizing hormone (LH) level decreased.

Materials and methods

Patients aged 27 to 42years (36.1 ± 3.79) underwent 308 IVF cycles who opted for IVF via the mild ovarian stimulation protocol began clomiphene citrate on day 3 and recombinant FSH on day 5. A GnRH antagonist was administered when the dominant follicle reached 14mm. Serum LH was measured at the time of GnRH antagonist administration and at the time of hCG injection. The pregnancy rate and implantation rate were compared between 50 cycles in which the LH level dropped less than one-third and the control (LH level within 1/3).

Result(s)

The pregnancy rate for the group in which the LH level fell less than one third was 18%. Conversely, the pregnancy rate for the control group was 39%. The implantation rate was 18% for the less than one-third group and 26% for the control group. Both the pregnancy rate and the implantation rate for the group in which the LH level fell less than one-third were significantly lower than that of control (p < 0.02).

Conslusion(s)

When performing the mild ovarian stimulation protocol, serum LH should be followed. If the serum LH level is less than one-third at the time of hCG injection, both the pregnancy rate and implantation rate are significantly lower.
Literatur
1.
Zurück zum Zitat Branigan EF, Estes MA. Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression. Fertil Steril 2000;73(3):587–90.PubMedCrossRef Branigan EF, Estes MA. Minimal stimulation IVF using clomiphene citrate and oral contraceptive pill pretreatment for LH suppression. Fertil Steril 2000;73(3):587–90.PubMedCrossRef
2.
Zurück zum Zitat Weigert M, Krischker U, Pohl M, Poschalko G, Kindermann C, Feichtinger W. Comparison of stimulation with clomiphene citrate in combination with recombinant follicle-stimulating hormone and recombinant luteinizing hormone to stimulation with a gonadotropin-releasing hormone agonist protocol: a prospective, randomized study. Fertil Steril 2002;78(1):34–9.PubMedCrossRef Weigert M, Krischker U, Pohl M, Poschalko G, Kindermann C, Feichtinger W. Comparison of stimulation with clomiphene citrate in combination with recombinant follicle-stimulating hormone and recombinant luteinizing hormone to stimulation with a gonadotropin-releasing hormone agonist protocol: a prospective, randomized study. Fertil Steril 2002;78(1):34–9.PubMedCrossRef
3.
Zurück zum Zitat Williams SC, Gibbons WE, Muasher SJ, Oehninger S. Minimal ovarian hyperstimulation for in vitro fertilization using sequential clomiphene citrate and gonadotropin with or without the addition of a gonadotropin-releasing hormone antagonist. Fertil Steril 2002;78(5):1068–72.PubMedCrossRef Williams SC, Gibbons WE, Muasher SJ, Oehninger S. Minimal ovarian hyperstimulation for in vitro fertilization using sequential clomiphene citrate and gonadotropin with or without the addition of a gonadotropin-releasing hormone antagonist. Fertil Steril 2002;78(5):1068–72.PubMedCrossRef
4.
Zurück zum Zitat Craft I, Gorgy A, Hill J, Menon D, Podsiadly B. Will GnRH antagonists provide new hope for patients considered ‘difficult responders’ to GnRH agonist protocols? Hum Reprod 1999;14(12):2959–62.PubMedCrossRef Craft I, Gorgy A, Hill J, Menon D, Podsiadly B. Will GnRH antagonists provide new hope for patients considered ‘difficult responders’ to GnRH agonist protocols? Hum Reprod 1999;14(12):2959–62.PubMedCrossRef
5.
Zurück zum Zitat Nikolettos N, Al-Hasani S, Felberbaum R, Demirel LC, Kupker W, Montzka P, et al. Gonadotropin-releasing hormone antagonist protocol: a novel method of ovarian stimulation in poor responders. Eur J Obstet Gynecol Reprod Biol 2001;97(2):202–7.PubMedCrossRef Nikolettos N, Al-Hasani S, Felberbaum R, Demirel LC, Kupker W, Montzka P, et al. Gonadotropin-releasing hormone antagonist protocol: a novel method of ovarian stimulation in poor responders. Eur J Obstet Gynecol Reprod Biol 2001;97(2):202–7.PubMedCrossRef
6.
Zurück zum Zitat Tavaniotou A, Albano C, Smitz J, Devroey P. Effect of clomiphene citrate on follicular and luteal phase luteinizing hormone concentrations in in vitro fertilization cycles stimulated with gonadotropins and gonadotropin-releasing hormone antagonist. Fertil Steril 2002;77(4):733–7.PubMedCrossRef Tavaniotou A, Albano C, Smitz J, Devroey P. Effect of clomiphene citrate on follicular and luteal phase luteinizing hormone concentrations in in vitro fertilization cycles stimulated with gonadotropins and gonadotropin-releasing hormone antagonist. Fertil Steril 2002;77(4):733–7.PubMedCrossRef
7.
Zurück zum Zitat Hwang JL, Huang LW, Hsieh BC, Tsai YL, Huang SC, Chen CY, et al. Ovarian stimulation by clomiphene citrate and hMG in combination with cetrorelix acetate for ICSI cycles. Hum Reprod 2003;18(1):45–9.PubMedCrossRef Hwang JL, Huang LW, Hsieh BC, Tsai YL, Huang SC, Chen CY, et al. Ovarian stimulation by clomiphene citrate and hMG in combination with cetrorelix acetate for ICSI cycles. Hum Reprod 2003;18(1):45–9.PubMedCrossRef
8.
Zurück zum Zitat Olivennes F, Alvarez S, Bouchard P, Fanchin R, Salat-Baroux J, Frydman R. The use of a GnRH antagonist (Cetrorelix) in a single dose protocol in IVF-embryo transfer: a dose finding study of 3 versus 2 mg. Hum Reprod 1998;13(9):2411–4.PubMedCrossRef Olivennes F, Alvarez S, Bouchard P, Fanchin R, Salat-Baroux J, Frydman R. The use of a GnRH antagonist (Cetrorelix) in a single dose protocol in IVF-embryo transfer: a dose finding study of 3 versus 2 mg. Hum Reprod 1998;13(9):2411–4.PubMedCrossRef
9.
Zurück zum Zitat Diedrich K, Diedrich C, Santos E, Bauer O, Zoll C, al-Hasani S, et al. [Suppression of endogenous LH increase in ovarian stimulation with the GnRH antagonist Cetrorelix]. Geburtshilfe Frauenheilkd 1994;54(4):237–40.PubMedCrossRef Diedrich K, Diedrich C, Santos E, Bauer O, Zoll C, al-Hasani S, et al. [Suppression of endogenous LH increase in ovarian stimulation with the GnRH antagonist Cetrorelix]. Geburtshilfe Frauenheilkd 1994;54(4):237–40.PubMedCrossRef
10.
Zurück zum Zitat Albano C, Felberbaum RE, Smitz J, Riethmuller-Winzen H, Engel J, Diedrich K, et al. Ovarian stimulation with HMG: results of a prospective randomized phase III European study comparing the luteinizing hormone-releasing hormone (LHRH)-antagonist cetrorelix and the LHRH-agonist buserelin. European Cetrorelix Study Group. Hum Reprod 2000;15(3):526–31.PubMedCrossRef Albano C, Felberbaum RE, Smitz J, Riethmuller-Winzen H, Engel J, Diedrich K, et al. Ovarian stimulation with HMG: results of a prospective randomized phase III European study comparing the luteinizing hormone-releasing hormone (LHRH)-antagonist cetrorelix and the LHRH-agonist buserelin. European Cetrorelix Study Group. Hum Reprod 2000;15(3):526–31.PubMedCrossRef
11.
Zurück zum Zitat Hohmann FP, Macklon NS, Fauser BC. A randomized comparison of two ovarian stimulation protocols with gonadotropin-releasing hormone (GnRH) antagonist cotreatment for in vitro fertilization commencing recombinant follicle-stimulating hormone on cycle day 2 or 5 with the standard long GnRH agonist protocol. J Clin Endocrinol Metab 2003;88(1):166–73.PubMedCrossRef Hohmann FP, Macklon NS, Fauser BC. A randomized comparison of two ovarian stimulation protocols with gonadotropin-releasing hormone (GnRH) antagonist cotreatment for in vitro fertilization commencing recombinant follicle-stimulating hormone on cycle day 2 or 5 with the standard long GnRH agonist protocol. J Clin Endocrinol Metab 2003;88(1):166–73.PubMedCrossRef
12.
Zurück zum Zitat Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 1998;13(12):3434–40.PubMedCrossRef Gardner DK, Schoolcraft WB, Wagley L, Schlenker T, Stevens J, Hesla J. A prospective randomized trial of blastocyst culture and transfer in in-vitro fertilization. Hum Reprod 1998;13(12):3434–40.PubMedCrossRef
13.
Zurück zum Zitat Pelinck MJ, Vogel NE, Hoek A, Arts EG, Simons AH, Heineman MJ. Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study. Hum Reprod 2005;20(3):642–8.PubMedCrossRef Pelinck MJ, Vogel NE, Hoek A, Arts EG, Simons AH, Heineman MJ. Minimal stimulation IVF with late follicular phase administration of the GnRH antagonist cetrorelix and concomitant substitution with recombinant FSH: a pilot study. Hum Reprod 2005;20(3):642–8.PubMedCrossRef
14.
Zurück zum Zitat Weghofer A, Margreiter M, Bassim S, Sevelda U, Beilhack E, Feichtinger W. Minimal stimulation using recombinant follicle-stimulating hormone and a gonadotropin-releasing hormone antagonist in women of advanced age. Fertil Steril 2004;81(4):1002–6.PubMedCrossRef Weghofer A, Margreiter M, Bassim S, Sevelda U, Beilhack E, Feichtinger W. Minimal stimulation using recombinant follicle-stimulating hormone and a gonadotropin-releasing hormone antagonist in women of advanced age. Fertil Steril 2004;81(4):1002–6.PubMedCrossRef
15.
Zurück zum Zitat Minaretzis D, Alper MM, Oskowitz SP, Lobel SM, Mortola JF, Pavlou SN. Gonadotropin-releasing hormone antagonist versus agonist administration in women undergoing controlled ovarian hyperstimulation: cycle performance and in vitro steroidogenesis of granulosa-lutein cells. Am J Obstet Gynecol 1995;172(5):1518–25.PubMedCrossRef Minaretzis D, Alper MM, Oskowitz SP, Lobel SM, Mortola JF, Pavlou SN. Gonadotropin-releasing hormone antagonist versus agonist administration in women undergoing controlled ovarian hyperstimulation: cycle performance and in vitro steroidogenesis of granulosa-lutein cells. Am J Obstet Gynecol 1995;172(5):1518–25.PubMedCrossRef
16.
Zurück zum Zitat Eldar-Geva T, Zylber-Haran E, Babayof R, Halevy-Shalem T, Ben-Chetrit A, Tsafrir A, et al. Similar outcome for cryopreserved embryo transfer following GnRH-antagonist/GnRH-agonist, GnRH-antagonist/HCG or long protocol ovarian stimulation. Reprod Biomed Online 2007;14(2):148–54.PubMedCrossRef Eldar-Geva T, Zylber-Haran E, Babayof R, Halevy-Shalem T, Ben-Chetrit A, Tsafrir A, et al. Similar outcome for cryopreserved embryo transfer following GnRH-antagonist/GnRH-agonist, GnRH-antagonist/HCG or long protocol ovarian stimulation. Reprod Biomed Online 2007;14(2):148–54.PubMedCrossRef
17.
Zurück zum Zitat Lee JR, Choi YS, Jee BC, Ku SY, Suh CS, Kim KC, et al. Cryopreserved blastocyst transfer: impact of gonadotropin-releasing hormone agonist versus antagonist in the previous oocyte retrieval cycles. Fertil Steril 2007;88(5):1344–9.PubMedCrossRef Lee JR, Choi YS, Jee BC, Ku SY, Suh CS, Kim KC, et al. Cryopreserved blastocyst transfer: impact of gonadotropin-releasing hormone agonist versus antagonist in the previous oocyte retrieval cycles. Fertil Steril 2007;88(5):1344–9.PubMedCrossRef
18.
Zurück zum Zitat Tesarik J, Hazout A, Mendoza C. Luteinizing hormone affects uterine receptivity independently of ovarian function. Reprod Biomed Online 2003;7(1):59–64.PubMedCrossRef Tesarik J, Hazout A, Mendoza C. Luteinizing hormone affects uterine receptivity independently of ovarian function. Reprod Biomed Online 2003;7(1):59–64.PubMedCrossRef
19.
Zurück zum Zitat Licht P, von Wolff M, Berkholz A, Wildt L. Evidence for cycle-dependent expression of full-length human chorionic gonadotropin/luteinizing hormone receptor mRNA in human endometrium and decidua. Fertil Steril 2003;79(Suppl 1):718–23.PubMedCrossRef Licht P, von Wolff M, Berkholz A, Wildt L. Evidence for cycle-dependent expression of full-length human chorionic gonadotropin/luteinizing hormone receptor mRNA in human endometrium and decidua. Fertil Steril 2003;79(Suppl 1):718–23.PubMedCrossRef
20.
Zurück zum Zitat Ziecik AJ, Bodek G, Blitek A, Kaczmarek M, Waclawik A. Nongonadal LH receptors, their involvement in female reproductive function and a new applicable approach. Vet J 2005;169(1):75–84.PubMedCrossRef Ziecik AJ, Bodek G, Blitek A, Kaczmarek M, Waclawik A. Nongonadal LH receptors, their involvement in female reproductive function and a new applicable approach. Vet J 2005;169(1):75–84.PubMedCrossRef
21.
Zurück zum Zitat Kawate N, Tsuji M, Tamada H, Inaba T, Sawada T. Inhibition of luteinizing hormone receptor expression during the development of caprine corpora lutea by administration of gonadotropin-releasing hormone antagonist. Mol Reprod Dev 2002;63(4):444–50.PubMedCrossRef Kawate N, Tsuji M, Tamada H, Inaba T, Sawada T. Inhibition of luteinizing hormone receptor expression during the development of caprine corpora lutea by administration of gonadotropin-releasing hormone antagonist. Mol Reprod Dev 2002;63(4):444–50.PubMedCrossRef
Metadaten
Titel
The decrease of serum luteinizing hormone level by a gonadotropin-releasing hormone antagonist following the mild IVF stimulation protocol for IVF and its clinical outcome
verfasst von
Atsushi Yanaihara
Takeshi Yorimitsu
Hiroshi Motoyama
Motohiro Ohara
Toshihiro Kawamura
Publikationsdatum
01.04.2008
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 4/2008
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-008-9205-6

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