Document Detail

Cessation of gonadotropin-releasing hormone agonist therapy combined with high-dose gonadotropin stimulation yields favorable pregnancy results in low responders.
MedLine Citation:
PMID:  9591487     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the pregnancy results of an ovarian hyperstimulation protocol for IVF-ET that combines GnRH agonist down-regulation, cessation of GnRH agonist therapy with the onset of menstruation, and high-dose gonadotropin administration in low responders. DESIGN: Prospective analysis. SETTING: Academic IVF program. PATIENT(S): One hundred eighty-two low responders undergoing 224 IVF-ET cycles. INTERVENTION(S): Down-regulation was obtained with the administration of leuprolide acetate beginning in the midluteal phase and ending with the onset of menses. Daily administration of 6 ampules of FSH alone or in combination with hMG was initiated on cycle day 3. MAIN OUTCOME MEASURE(S): Stimulation characteristics and pregnancy rates (PRs) were compared between fresh cycles in which pure FSH alone was used and 35 cycles in which a combination of FSH and hMG was administered. RESULT(S): The clinical PR per transfer, the ongoing PR per transfer, and the implantation rate were 32%, 24%, and 9%, respectively. No differences were noted between cycles in which pure FSH alone was used in comparison with cycles in which a combination of FSH and hMG was administered. CONCLUSION(S): Short-term ovarian suppression begun in the luteal phase and discontinued with the onset of menses followed by high-dose stimulation with gonadotropins yields favorable pregnancy results in low responders.
B M Faber; J Mayer; B Cox; D Jones; J P Toner; S Oehninger; S J Muasher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Fertility and sterility     Volume:  69     ISSN:  0015-0282     ISO Abbreviation:  Fertil. Steril.     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-05-28     Completed Date:  1998-05-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  826-30     Citation Subset:  IM    
Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, USA.
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MeSH Terms
Embryo Transfer*
Fertilization in Vitro*
Follicle Stimulating Hormone / administration & dosage*
Leuprolide / therapeutic use*
Luteinizing Hormone / blood
Menotropins / administration & dosage
Prospective Studies
Reg. No./Substance:
53714-56-0/Leuprolide; 61489-71-2/Menotropins; 9002-67-9/Luteinizing Hormone; 9002-68-0/Follicle Stimulating Hormone
Comment In:
Fertil Steril. 1998 Oct;70(4):783   [PMID:  9797118 ]
Fertil Steril. 2001 Jan;75(1):226-7   [PMID:  11229332 ]
Fertil Steril. 1998 Oct;70(4):783-5   [PMID:  9797119 ]

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