Consequences on gonadotrophin secretion of an early discontinuation of gonadotrophin-releasing hormone agonist administration in short-term protocol for in-vitro fertilization.

Administration of gonadotrophin-releasing hormone (GnRHa) agonists, used in IVF short-term protocols to initiate follicular recruitment, may be restricted to the early follicular phase without any further risk of LH surge. However, consequences of an early discontinuation upon residual endogenous gonadotrophin secretion are still unknown. Here, the effects of early cessation of GnRH agonist upon gonadotrophin secretion and ovarian parameters of IVF cycles were investigated. A total of 230 normo-ovulatory women were prospectively allocated to one of the two regimens: decapeptyl-GnRH (100 microgram) was daily injected either from day 1 to the triggering of ovulation (group 1) or for the first 7 days (group 2). Exogenous gonadotrophins (150 IU) were administered on day 4 and 5 with a subsequent adjustment. Detections of free alpha subunit and dimeric LH were performed by highly specific 'two site' monoclonal immunoradiometric assays. The results show that early discontinuation of GnRH agonist administration was associated with a sharp decrease in both plasma free alpha subunit and dimeric LH concentrations while plasma oestradiol response to exogenous gonadotrophins was reduced. Other ovarian parameters and pregnancy rate were unchanged. These data indicate that endogenous LH secretion is maintained by a daily administration of GnRH agonist and may contribute to the final follicular maturation.

[1]  Y. Saito,et al.  A prospective randomized comparison between long and discontinuous-long protocols of gonadotropin-releasing hormone agonist for in vitro fertilization. , 1997, Fertility and sterility.

[2]  P. Chanson,et al.  Free luteinizing-hormone beta-subunit in normal subjects and patients with pituitary adenomas. , 1997, The Journal of clinical endocrinology and metabolism.

[3]  E. Loumaye,et al.  Assessment of the role of serum luteinizing hormone and estradiol response to follicle-stimulating hormone on in vitro fertilization treatment outcome. , 1997, Fertility and sterility.

[4]  S. Hillier.  Roles of follicle stimulating hormone and luteinizing hormone in controlled ovarian hyperstimulation. , 1996, Human reproduction.

[5]  E. Schoute,et al.  Short term pituitary desensitization: effects of different doses of the gonadotrophin-releasing hormone agonist triptorelin. , 1996, Human reproduction.

[6]  D. Valbuena,et al.  Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. , 1995, Human reproduction.

[7]  R. Jansen,et al.  Profound luteinizing hormone suppression after stopping the gonadotropin-releasing hormone-agonist leuprolide acetate. , 1995, Fertility and sterility.

[8]  S. Monroe,et al.  Contrasting effects of a gonadotropin-releasing hormone agonist and antagonist on the secretion of free alpha subunit. , 1994, Fertility and sterility.

[9]  R. Frydman,et al.  Comparison of short 7-day and prolonged treatment with gonadotropin-releasing hormone agonist desensitization for controlled ovarian hyperstimulation. , 1993, Fertility and sterility.

[10]  S. Irvine,et al.  Prospective study of short and ultrashort regimens of gonadotropin‐releasing hormone agonist in an in vitro fertilization program , 1993, Fertility and sterility.

[11]  K. Gordon,et al.  Interval required for gonadotropin-releasing hormone-agonist-induced down regulation of the pituitary in cynomolgus monkeys and duration of the refractory state. , 1992, Fertility and sterility.

[12]  I. Huhtaniemi,et al.  Differing responses of plasma bioactive and immunoreactive follicle-stimulating hormone and luteinizing hormone to gonadotropin-releasing hormone antagonist and agonist treatments in postmenopausal women. , 1992, The Journal of clinical endocrinology and metabolism.

[13]  M. Attalah,et al.  Effects of short-term GnRH agonist--human menopausal gonadotrophin stimulation in patients pre-treated with progestogen. , 1992, Human reproduction.

[14]  W. Crowley,et al.  Effects of chronic GnRH analogue administration on gonadotrophin and α‐subunit secretion in post‐menopausal women , 1992, Clinical endocrinology.

[15]  A. Lemay,et al.  Gonadotrophin releasing hormone agonist suppressive treatment of ovarian function decreases serum LH‐β and bloactive LH but maintains elevated levels of LH‐α , 1991 .

[16]  S. Lamberts,et al.  PROLONGED TREATMENT WITH THE GnRH ANALOGUE BUSERELIN DOES NOT AFFECT α‐SUBUNIT PRODUCTION BY THE PITUITARY GONADOTROPH , 1990, Clinical endocrinology.

[17]  R. Edwards,et al.  Short-term luteinizing hormone-releasing hormone agonist treatment: prospective trial of a novel ovarian stimulation regimen for in vitro fertilization. , 1989, Fertility and sterility.

[18]  W. Crowley,et al.  Gonadotropin and alpha-subunit responses to chronic gonadotropin-releasing hormone analog administration in patients with glycoprotein hormone-secreting pituitary tumors. , 1989, The Journal of clinical endocrinology and metabolism.

[19]  R. Frydman,et al.  LHRH agonists in IVF: different methods of utilization and comparison with previous ovulation stimulation treatments. , 1988, Human reproduction.

[20]  R. Clayton,et al.  Gonadotropin-releasing hormone desensitization preferentially inhibits expression of the luteinizing hormone beta-subunit gene in vivo. , 1988, Endocrinology.

[21]  I. Huhtaniemi,et al.  Serum bioactive and immunoreactive follicle-stimulating hormone in prostatic cancer patients during gonadotropin-releasing hormone agonist treatment and after orchidectomy. , 1988, The Journal of clinical endocrinology and metabolism.

[22]  A. Schally,et al.  Gonadotropin and alpha-subunit secretion during long term pituitary suppression by D-Trp6-luteinizing hormone-releasing hormone microcapsules as treatment of precocious puberty. , 1987, The Journal of clinical endocrinology and metabolism.

[23]  R. Frydman,et al.  Physiological Studies of Human Chorionic Gonadotropin (hCG), αhCG, and βhCG as Measured by Specific Monoclonal Immunoradiometric Assays , 1987 .

[24]  R. Frydman,et al.  Physiological studies of human chorionic gonadotropin (hCG), alpha hCG, and beta hCG as measured by specific monoclonal immunoradiometric assays. , 1987, Endocrinology.

[25]  G. Braunstein,et al.  Stimulation of LH fragments with reduced bioactivity following GnRH agonist administration in women. , 1984, The Journal of clinical endocrinology and metabolism.

[26]  D. Krieger,et al.  The luteinizing hormone-releasing hormone (LHRH) agonist [D-Trp6-Pro9-NEt]LHRH increased rather than lowered LH and alpha-subunit levels in a patient with an LH-secreting pituitary tumor. , 1984, The Journal of clinical endocrinology and metabolism.

[27]  J. Lindner,et al.  A luteinizing hormone-releasing hormone agonist decreases biological activity and modifies chromatographic behavior of luteinizing hormone in man. , 1984, The Journal of clinical investigation.