Clinical and endocrine response to the withdrawal of gonadotropin-releasing hormone agonists during prolonged coasting

Fertility and Sterility
Basil Ho YuenPeter C K Leung

Abstract

To compare the clinical and endocrine response of cycles in which GnRH agonists (GnRH-a) were stopped with cycles in which the agonists were continued during coasting. Retrospective study of stimulation cycles using flare and luteal agonist protocols. Academic. Fifty-nine IVF and intracytoplasmic sperm injection (ICSI) treatment cycles in 57 women, coasted for 3 or more days. The GnRH-a were withdrawn when E(2) levels continued to increase during coasting. Hormone concentrations, ultrasound findings, cycle cancellation, ovarian hyperstimulation syndrome (OHSS), oocyte retrieval, fertilization, embryo transfer, and clinical pregnancy rates (PR). In the GnRH-a withdrawn group E(2) levels decreased by 63% (18,043-6,656 pmol/L) without cycle cancellations or cases of severe OHSS. In the agonist continuation group, the spontaneous E(2) decrease was 29% (14,205-10,132 pmol/L) with cycle cancellation and severe OHSS rates of 9.5% (4/42) and 4.8% (2/42), respectively. Oocyte retrieval, fertilization, embryo transfer, and clinical PRs were not compromised by stopping the agonists. Variations in the dynamic responses of FSH, LH, anti-Müllerian hormone, P, and androstenedione (A) levels in these cycles are described. Withdrawal of GnRH-a ...Continue Reading

References

Nov 1, 1985·Journal of Steroid Biochemistry·T MaruoM Mochizuki
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Apr 1, 1983·Biology of Reproduction·C S Sheela RaniT Hillensjö
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Oct 24, 2006·Fertility and Sterility·UNKNOWN Practice Committee of the American Society for Reproductive Medicine

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Citations

Feb 9, 2010·Journal of Assisted Reproduction and Genetics·Carolina O NastriWellington P Martins
Apr 21, 2012·International Journal of Endocrinology·Srisailesh VitthalaTalha Al-Shawaf
Jun 15, 2013·Reproductive Biomedicine Online·Li-Jun DingHai-Xiang Sun

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