Document Detail


Relationship between gonadotropin releasing hormone agonist dosage and in vitro fertilization outcome.
MedLine Citation:
PMID:  15195497     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective study in 132 women undergoing in vitro fertilization was performed in order to assess whether lower doses of gonadotropin releasing hormone agonists (GnRH-a) may ensure adequate oocyte retrieval and pregnancy rate, without pituitary oversuppression. Forty-five patients received subcutaneous tryptorelin depot (Decapeptyl 3.75, IPSEN SpA), 41 received subcutaneous tryptorelin acetate daily (Decapeptyl 0.1 mg, IPSEN SpA) and 46 received 0.05 mg tryptorelin acetate daily from day 21 of the cycle. From day 3 of the new cycle, if the estradiol levels were < 30 pg/ml, patients received two or three ampules of gonadotropin daily. In the group receiving subcutaneous tryptorelin acetate depot, the mean number of total gonadotropin ampules was significantly higher (p < 0.05), otherwise estradiol levels and the number of oocytes retrieved, fertilized and cleaved were significantly lower (p < 0.05). Pituitary oversuppression induced by GnRH-a causes an increase in the gonadotropin requirement for assisted reproductive techniques (ART) and a reduction in the number of oocytes retrieved and fertilized. There is a high risk of oversuppression in normal-weight or underweight women, because there is greater bioavailability of the peptide, hence elevated circulating levels of GnRH-a. Thus, ovarian stimulation in ART cycles depends on many factors, not least the identification of the best GnRH-a dose.
Authors:
F Lorusso; R Depalo; L Selvaggi
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology     Volume:  18     ISSN:  0951-3590     ISO Abbreviation:  Gynecol. Endocrinol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-06-15     Completed Date:  2004-07-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8807913     Medline TA:  Gynecol Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  69-73     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Bari, Bari, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Dose-Response Relationship, Drug
Estradiol / blood
Female
Fertilization in Vitro*
Gonadotropin-Releasing Hormone / agonists*
Humans
Injections, Subcutaneous
Oocytes / drug effects*,  physiology
Ovulation Induction*
Prospective Studies
Triptorelin / administration & dosage*
Chemical
Reg. No./Substance:
33515-09-2/Gonadotropin-Releasing Hormone; 50-28-2/Estradiol; 57773-63-4/Triptorelin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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