Advertisement

Journal of Assisted Reproduction and Genetics

, Volume 15, Issue 8, pp 478–484 | Cite as

The Effects of Gonadotropin-Releasing Hormone Agonist on Androstenedione Production and Follicular Development During Controlled Ovarian Hyperstimulation

  • Kouichi Akaboshi
  • Takahisa Oda
  • Joji Yoshida
  • Satoshi Kohriyama
  • Toyohiko Miyazaki
  • Yasunori Yoshimura
Article

Abstract

Purpose: We performed a prospective randomized study to assess the effects of a GnRH agonist (GnRH-a) onfollicular development and steroidogenesis during controlled ovarian hyperstimulation (COH).

Methods: Patients undergoing in vitro fertilization (IVF)for tubal infertility received human menopausal gonadotropin (hMG) stimulation with or without the GnRH-a, buserelin, beginning in the midluteal phase of the prior cycle. We analyzed serum hormone levels, follicular development, and outcome of IVF.

Results: The mean number of retrieved oocytes was significantly greater, and the implantation rate per embryo was significantly higher, in the GnRH-a/hMG group (n = 101) than in the hMG-only group (n = 97). The concentration of androstenedione (A) and the A/estradiol ratio in the serum were significantly lower in the GnRH-a treatment group throughout the follicular phase.

Conclusions: The concomitant use of GnRH-a during COH prevents atretic change of the follicles and enhances follicular development by reducing androgen accumulation, resulting in a higher developmental competence of the oocytes.

androstenedione controlled ovarian hyperstimulation follicular atresia gonadotropin-releasing hormone agonist in vitro fertilization 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. 1.
    Palermo R, Amodeo G, Navot D, Rosenwaks Z, Cittadini E: Concomitant gonadotropin-releasing hormone agonist and menotropin treatment for the synchronized induction of multiple follicles. Fertil Steril 1988;49:290–295Google Scholar
  2. 2.
    Neveu S, Hedon B, Bringer J, Chinchole J, Arnal F, Humeau C, Cristol P, Viala J: Ovarian stimulation by a combination of a gonadotropin-releasing hormone agonist and gonadotropins for in vitro fertilization. Fertil Steril 1987;47:639–643Google Scholar
  3. 3.
    Chetkowski RJ, Kruse LR, Nass TE: Improved pregnancy outcome with the addition of leuprolide acetate to gonadotropins for in vitro fertilization. Fertil Steril 1989;52:250–255Google Scholar
  4. 4.
    Droesch K, Muasher SJ, Brzyski RG, Jones GS, Simonetti S, Liu H, Rosenwaks Z: Value of suppression with a gonadotropin-releasing hormone agonist prior to gonadotropin stimulation for in vitro fertilization. Fertil Steril 1989;51:292–297Google Scholar
  5. 5.
    Fleming R, Coutts JRT: Induction of multiple follicular growth in normally menstruating women with endogenous gonadotropin suppression. Fertil Steril 1986;45:226–230Google Scholar
  6. 6.
    Lejeune B, Deguelder M, Camus M, Vekemans M, Opsomer L, Leroy F: In vitro fertilization and embryo transfer as related to endogenous luteinizing hormone rise or human chorionic gonadotropin administration. Fertil Steril 1986;45:377–383Google Scholar
  7. 7.
    Silverberg KM, Burns WN, Olive DL, Riehl RM, Schenken RS: Serum progesterone levels predict success of in vitro fertilization/embryo transfer in patients stimulated with leuprolide acetate and human menopausal gonadotropins. J Clin Endocrinol Metab 1991;73:797–803Google Scholar
  8. 8.
    Hofmann GE, Bentzien F, Bergh PA, Garrisi GJ, Williams MC, Guzman I, Navot D: Premature luteinization in controlled ovarian hyperstimulation has no adverse effect on oocyte and embryo quality. Fertil Steril 1993;60:675–679Google Scholar
  9. 9.
    Yovel I, Yaron Y, Amit A, Peyser MR, David MP, Kogosowski A, Lessing JB: High progesterone levels adversely affect embryo quality and pregnancy rates in in vitro fertilization and oocyte donation programs. Fertil Steril 1995;64:128–131Google Scholar
  10. 10.
    Billig H, Furuta I, Hsueh AJW: Estrogens inhibit and androgens enhance ovarian granulosa cell apoptosis. Endocrinology 1993;133:2204–2212Google Scholar
  11. 11.
    Billig H, Furuta I, Hsueh AJW: Gonadotropin-releasing hormone directly induces apoptotic cell death in the rat ovary: biochemical and in situ detection of deoxyribonucleic acid fragmentation in granulosa cells. Endocrinology 1994;134:245–252Google Scholar
  12. 12.
    McNatty KP, Smith DM, Makris A, Osathanondh R, Ryan KJ: The microenvironment of the human antral follicle: interrelationships among the steroid levels in antral fluid, the population of granulosa cells, and the status of the oocyte in vivo and in vitro. J Clin Endocrinol Metab 1979;49:851–860Google Scholar
  13. 13.
    Kobayashi T, Oda T, Yoshimura Y, Takehara Y, Natori M, Nozawa S: Androstenedione and progesterone concentrations in preovulatory follicular fluid correlate with successful fertilization and cleavage of human oocytes in vitro. Fertil Steril 1991;56:301–305Google Scholar
  14. 14.
    Brailly S, Gougeon A, Milgrom E, Bomsel-Helmerich O, Papiernik E: Androgens and progestins in the human ovarian follicle: differences in the evolution of preovulatory, healthy nonovulatory, and atretic follicles. J Clin Endocrinol Metab 1981;53:128–134Google Scholar
  15. 15.
    Oda T, Yoshimura Y, Izumi Y, Yoshimura S, Hara T, Takehara Y, Nakamura Y, Ohno T: The effect of the follicular fluid adenosine 3′,5′-monophosphate degradation rate on successful fertilization and cleavage of human oocytes. J Clin Endocrinol Metab 1990;71:116–121Google Scholar
  16. 16.
    Judd HL, Yen SSC: Serum androstenedione and testosterone levels during the menstrual cycle. J Clin Endocrinol Metab 1973;36:475–481Google Scholar
  17. 17.
    Abraham GE: Ovarian and adrenal contribution to peripheral androgens during the menstrual cycle. J Clin Endocrinol Metab 1974;39:340–346Google Scholar
  18. 18.
    Tureck RW, Mastroianni L Jr, Blasco L, Strauss JF III: Inhibition of human granulosa cell progesterone secretion by a gonadotropin-releasing hormone agonist. J Clin Endocrinol Metab 1982;54:1078–1080Google Scholar
  19. 19.
    Bussenot I, Azoulay-Barjonet C, Parinaud J: Modulation of the steroidogenesis of cultured human granulosa-lutein cells by gonadotropin-releasing hormone analogs. J Clin Endocrinol Metab 1993;76:1376–1379Google Scholar
  20. 20.
    Loumaye E, Coen G, Pampfer S, Vankrieken L, Thomas K: Use of a gonadotropin-releasing hormone agonist during ovarian stimulation leads to significant concentrations of peptide in follicular fluids. Fertil Steril 1989;52:256–263Google Scholar
  21. 21.
    Latouche J, Crumeyrolle-Arias M, Jordan D, Kopp N, Augendre-Ferrante, Cedard L, Haour F: GnRH receptors in human granulosa cells: Anatomical localization and characterization by autoradiographic study. Endocrinology 1989;125:1739–1741Google Scholar
  22. 22.
    Meldrum DR, Tsao Z, Monroe SE, Braunstein GD, Sladek J, Lu JKH, Vale W, Rivier J, Judd HL, Chang RJ: Stimulation of LH fragments with reduced bioactivity following GnRH agonist administration in women. J Clin Endocrinol Metab 1984;58:755–757Google Scholar
  23. 23.
    Cedars MI, Surey E, Hamilton F, Lapolt P, Meldrum DR: Leuprolide acetate lowers circulating bioactive luteinizing hormone and testosterone concentrations during ovarian stimulation for oocyte retrieval. Fertil Steril 1990;53:627–631Google Scholar
  24. 24.
    Rose GL, Dowsett M, Mudge JE, White JO, Jeffcoate SL: The inhibitory effects of danazol, danazol metabolites, gestrinone, and testosterone on the growth of human endometrial cells in vitro. Fertil Steril 1988;49:224–228Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • Kouichi Akaboshi
    • 1
  • Takahisa Oda
    • 1
  • Joji Yoshida
    • 1
  • Satoshi Kohriyama
    • 1
  • Toyohiko Miyazaki
    • 2
  • Yasunori Yoshimura
    • 2
  1. 1.Department of Obstetrics and GynecologyTokyo Dental College, Ichikawa General HospitalIchikawa CityJapan
  2. 2.Department of Obstetrics and GynecologyKeio University School of MedicineJapan

Personalised recommendations