Early and late hormonal responses to the microdose gonadotropin-releasing hormone agonist in normal menstruating women

Microdose follicular flare: a viable alternative for normal-responding patients undergoing in vitro fertilization?

“…Yet it appears that microdose GnRHa administration may have little effect on serum P levels, even after OCP pretreatment (16). In our program, neither LH nor P levels are routinely drawn.…”

Ovulation Stimulation with Gonadotropins

“…A second generation of highly purifi ed gonadotropin extract (HP-HMG, ( Menogon ® or Menopur ® )), was introduced later as an improvement due to several additional purifi cation steps. The LH effect is claimed to be partly related to the pituitary hCG present in the urine, and is important to balance the relative shortage of LH in the 30 post-menopausal urine. The existence of hCG secretion by the pituitary is still a matter of debate, and in any case it probably constitutes less than 1 % of the total LH bioactivity of menotropins preparations [Fostimon EU MRP registration, Personal communication to author].…”

“…It appears that any single dose between 15,000 and 30,000 IU rLH will be suffi cient to resume meiosis in a COH protocol [ 29 ]. In a classical stimulation, however, where LH must support the complete ovulatory process, results from studies in nonhuman primates suggested that a second administration of 2,500 IU 18 h after the fi rst was necessary to complete an LH effect over the 48-50 h required to rupture a follicle and develop a functional luteal gland [ 30 ]. Obviously, these results suggest that inadequate LH exposure may lead to a luteal insuffi ciency or a LUF syndrome.…”

“…The rates of chemical pregnancy, ectopic pregnancy, or spontaneous abortion are comparable whether progesterone administration is stopped on the fi rst day of a positive pregnancy test, or continued on up through three more weeks, or even longer [ 30 ].…”