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