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Luteinizing response to human chorionic gonadotropin does not predict outcome in gonadotropin releasing hormone agonist-suppressed/human menopausal gonadotropin-stimulated in vitro fertilization (IVF) cycles

  • Alan S. Penzias
  • Fayek N. Shamma
  • Jacqueline N. Gutmann
  • David B. Seifer
  • Alan H. DeCherney
  • Gad Lavy
Clinical Assisted Reproduction

Objective

The purpose of this study was to determine if early luteinizing potential in gonadotropin releasing hormone agonist (GnRH-a)-suppressed/human menopausal gonadotropin (hMG)-stimulated IVF cycles is predictive of cycle outcome.

Design, Patients

The study was a prospective evaluation of 41 women beginning a GnRH-a-suppressed/hMG-stimulated IVF cycle.

Setting

The in vitro fertilization program of a tertiary care institution was the study setting.

Main Outcome Measures

The main outcome measures were (1) estradiol (E2) and progesterone (P) levels on the day of human chorionic gonadotropin (hCG) administration and the following day and (2) the ovarian response to ovulation induction and clinical outcome.

Results

Ten of the 41 women achieved a clinical pregnancy (24.4%). There was no significant difference in progesterone (P) levels on the day of or the day following hCG administration between the pregnant and the nonpregnant groups. Both groups exhibited a significant rise in P level in response to hCG. There was no significant difference in E2 levels on the day of hCG between the two groups. The serum E2 did not rise significantly in response to hCG in either group. Patients who became pregnant had significantly more oocytes retrieved, fertilized, cleaved, and transferred.

Conclusions

Clinical response and outcome in GnRH-a-suppressed/hMG-stimulated IVF cycles are not predicted by early luteinizing potential as indicated by the response of E2 or P to hCG.

Key words

luteinizing response human chorionic gonadotropin gonadotropin releasing hormone agonist human menopausal gonadotropin periovulatory estradiol periovulatory progesterone in vitro fertilization 

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References

  1. 1.
    Frydman R, Parneix I, Belaisch-Allart J,et al. LHRH agonist in IVF: different methods of utilization and comparison with previous ovulation stimulation treatments. Hum Reprod 1988;3:559–561PubMedGoogle Scholar
  2. 2.
    Dodson WC: Role of gonadotropin releasing hormone agonist in ovulation induction. J Reprod Med 1989;34:76–80PubMedGoogle Scholar
  3. 3.
    Testart J, Forman R, Belaisch-Allart J,et al. Embryo quality and uterine receptivity in in-vitro fertilization cycles with or without agonist of gonadotrophin-releasing hormone. Hum Reprod 1989;4:198–201PubMedGoogle Scholar
  4. 4.
    Tur-Kapsa I, Confino E, Dudkiewicz AB, Myers SA, Friberg J, Gleicher N: Ovarian stimulation protocol for in vitro fertilization with gonadotropin-releasing hormone agonist widens the implantation window. Fertil Steril 1990;53:859–864PubMedGoogle Scholar
  5. 5.
    Laufer N, DeCherney AH, Tarlatzis BC, Naftolin F: The association between preovulatory serum 17β-estradiol pattern and conception in human menopausal gonadotropin-human chorionic gonadotropin stimulation. Fertil Steril 1986;46:73–76PubMedGoogle Scholar
  6. 6.
    Lopata A: Concepts in human in vitro fertilization and embryo transfer. Fertil Steril 1983;40:289–301PubMedGoogle Scholar
  7. 7.
    Jones HW Jr, Acosta A, Andrews MC,et al. The importance of the follicular phase to success and failure in in vitro fertilization. Fertil Steril 1983;40:317–321PubMedGoogle Scholar
  8. 8.
    Edelstein MC, Seltman HJ, Cox BJ, Robinson SM, Shaw RA, Muasher SJ: Progesterone levels on the day of human chorionic gonadotropin administration in cycles with gonadotropin-releasing hormone agonist are not predictive of pregnancy outcome. Fertil Steril 1990;54:853–857PubMedGoogle Scholar
  9. 9.
    Maclin VM, Radwanska E, Binor Z, Dmowski WP: Progesterone:estradiol ratios at implantation in ongoing pregnancies, abortions, and nonconception cycles resulting from ovulation induction. Fertil Steril 1990;54:238–244PubMedGoogle Scholar
  10. 10.
    Chenette PE, Sauer MV, Paulson RJ: Very high serum estradiol levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril 1990;54:858–863PubMedGoogle Scholar
  11. 11.
    Yovich JL, McColm SC, Yovich JM, Matson PL: Early luteal serum progesterone concentrations are higher in pregnancy cycles. Fertil Steril 1985;44:185–189PubMedGoogle Scholar
  12. 12.
    Dlugi AM, Laufer N, DeCherney AH,et al. The periovulatory and luteal phase of conception cycles following in vitro fertilization and embryo transfer. Fertil Steril 1984;41:530–537PubMedGoogle Scholar
  13. 13.
    WHO Task Force on Methods for the Determination of the Fertile Period: Temporal relationships between ovulation and defined changes in the concentration of plasma estradiol-17β, luteinizing hormone, follicle stimulating hormone and progesterone. 1. Probit analysis. Am J Obstet Gynecol 1980;138:383–390Google Scholar
  14. 14.
    Collins W, Jurkovic D, Bourne T, Kurjak A, Campbell S: Ovarian morphology, endocrine function and intrafollicular blood flow during the peri-ovulatory period. Hum Reprod 1991;6:319–324PubMedGoogle Scholar
  15. 15.
    Yen SSC: The human menstrual cycle: Neuroendocrine regulation.In Reproductive Endocrinology, 3rd ed, SSC Yen, RB Jaffe (eds). Philadelphia, W.B. Saunders, 1991, pp 273–308Google Scholar
  16. 16.
    Catt KJ, Dufau ML: Gonadotropic hormones: Biosynthesis, secretion, receptors, and actions.In Reproductive Endocrinology, 3rd ed, SSC Yen, RB Jaffe (eds). Philadelphia, W.B. Saunders, 1991, pp 105–155Google Scholar
  17. 17.
    Hutchinson-Williams KA, Lunenfeld B, Diamond MP, Lavy G, Boyers SP, DeCherney AH: Human chorionic gonadotropin, estradiol and progesterone profiles in conception and nonconception cycles in an in vitro fertilization program. Fertil Steril 1989;52:441–445PubMedGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Alan S. Penzias
    • 1
  • Fayek N. Shamma
    • 1
  • Jacqueline N. Gutmann
    • 1
  • David B. Seifer
    • 1
  • Alan H. DeCherney
    • 1
  • Gad Lavy
    • 1
  1. 1.Department of Obstetrics and Gynecology, Division of Reproductive EndocrinologyYale University School of MedicineNew HavenUSA

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