Comparison between depot and standard release triptoreline in in vitro fertilization: pituitary sensitivity, luteal function, pregnancy outcome, and perinatal results

Porcu, Eleonora; Prato, Luca Dal; Seracchioli, Renato; Fabbri, Raffaella; Longhi, Maria Serena; Flamigni, Carlo

doi:10.1016/s0015-0282(16)56827-7

Cited by 31 publications

(10 citation statements)

References 14 publications

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“…Constant GnRH agonist exposure results in down-regulating the pituitary GnRH receptor and de-coupling post receptor signaling mechanisms (40–42). Long GnRH agonist protocols still have suppressed LH levels 9 days after the agonist was discontinued (43,44). This decreased LH pulsatility does not allow for adequate progesterone to be produced by the corpus luteum.…”

Section: Discussionmentioning

confidence: 99%

Timing luteal support in assisted reproductive technology: a systematic review

Connell

Szatkowski

Terry

et al. 2015

Fertility and Sterility

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Objective To summarize the available published randomized controlled trial data regarding timing of progesterone supplementation during the luteal phase of patients undergoing ART. Design A systematic review. Setting Not applicable. Patient(s) Undergoing in vitro fertilization. Intervention(s) Different starting times of progesterone for luteal support. Main Outcome Measure(s) Clinical pregnancy and live birth. Results Five randomized controlled trials were identified that met inclusion criteria with a total of 872 patients. A planned meta-analysis was not performed due to a high degree of clinical heterogeneity in regards to the timing, dose, and route of progesterone. Two studies compared progesterone initiated before oocyte retrieval versus the day of oocyte retrieval and pregnancy rates were 5–12% higher when starting progesterone on the day of oocyte retrieval. One study compared starting progesterone on post retrieval day 6 versus day 3, reporting a 16% decrease in pregnancy in the day 6 group. Trials comparing progesterone start times on the day of oocyte retrieval versus two or three days post retrieval showed no significant differences in pregnancy. Conclusions There appears to be a window for progesterone start time between the evening of oocyte retrieval and day 3 after oocyte retrieval. While some studies have suggested a potential benefit in delaying vaginal progesterone start time to 2 days after oocyte retrieval, this review could not find randomized controlled trials to adequately assess this. Further randomized clinical trials are needed to better define progesterone start time for luteal support after ART.

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Section: Discussionmentioning

confidence: 99%

Timing luteal support in assisted reproductive technology: a systematic review

Connell

Szatkowski

Terry

et al. 2015

Fertility and Sterility

View full text Add to dashboard Cite

show abstract

“…It corresponds to the period necessary for the recovery of pituitary GnRH receptors and LH content. Its duration ranges from several weeks after injection of the long-acting form, to 5-8 days after daily injections of the short-acting form (20,21). This refractory period is observed even after a short course (7 days) of GnRH agonist administration (22).…”

Section: Discussionmentioning

confidence: 99%

“Empty follicle syndrome” after human error: pregnancy obtained after repeated oocyte retrieval in a gonadotropin-releasing hormone antagonist cycle

Snaifer

Hugues

Poncelet

et al. 2008

Fertility and Sterility

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“…There is also a significant difference between both groups studied in endogenous FSH levels following downregulation and on the day of hCG administration, the latter one reflecting an increased FSH stimulation dose applied to compensate for inadequate ovarian response observed during the course of stimulation in the low serum LH group. This difference in intensity of pituitary suppression between depot and low-dose daily GnRHa is known, with FSH levels being generally more stable than LH levels (11,17,18).…”

Section: Discussionmentioning

confidence: 99%

“…The amount of LH available for ovarian stimulation depends on the intensity of pituitary suppression and the dose of exogenous LH. Differences in various GnRHa concerning intensity, onset and duration of pituitary suppression have been demonstrated previously (11)(12)(13). A recent meta-analysis did not demonstrate significant differences between patients treated with depot or daily GnRH agonists in terms of pregnancy rate, but number of gonadotrophin ampoules and duration of stimulation (14).…”

Section: Introductionmentioning

confidence: 93%