Effects of pretreatment with estrogens on ovarian stimulation with gonadotropins in women with premature ovarian failure: a randomized, placebo-controlled trial

Tartagni, Massimo; Cicinelli, Ettore; Pergola, Giovanni De; Salvia, Maria Antonietta De; Lavopa, Cristina; Loverro, Giuseppe

doi:10.1016/j.fertnstert.2006.08.086

Cited by 103 publications

(91 citation statements)

References 14 publications

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“…For protocol B, instead of discontinuing estrogen before starting ovarian stimulation, we continued its use during stimulation. The first reason for this extended use was to prevent the rebound of endogenous gonadotropins and subsequent FSH receptor downregulation after E2 discontination [26,27]. Second, we hypothesized that extended use of estrogen through ovarian stimulation would enhance the stimulatory effect of FSH on granulosa cell FSH receptors and improve embryo quality.…”

Section: Discussionmentioning

confidence: 99%

Effect of estrogen priming through luteal phase and stimulation phase in poor responders in in-vitro fertilization

Chang

Han

Won

et al. 2011

J Assist Reprod Genet

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Purpose To verify whether a novel protocol administering E 2 during the luteal phase of the preceding cycle and during ovarian stimulation in GnRH antagonist cycle could enhance follicular response and hence improve outcomes in poor responders. Methods In this retrospective analysis, a total of 155 poor responder patients subjected to IVF/ICSI were analyzed. All the patients had history of more than one prior IVF cycle failure with poor response (less than 5 oocytes retrieved and/ or maximal E 2 level less than 500 pg/mL) by using conventional long agonist or antagonist protocol. In luteal E2 treatment protocol (n086), oral estradiol valerate 4 mg/day was initiated on luteal day 21 and either stopped at menstrual cycle day 3 (Protocol A, n028) or continued during the period of ovarian stimulation until the day of hCG injection (Protocol B, n058). IVF parameters and pregnancy outcome of luteal E2 treatments group were compared with a standard GnRH antagonist protocol (n069) which the patients received no hormonal pretreatment. Results Compared to standard GnRH antagonist protocol, cancellation rate was lower with luteal E2 group (15.1% vs 37.7%, p<0.01). Moreover, patients treated with luteal estrogen resulted in an increased number of oocytes retrieved (4.5±2.9 vs 3.2±1.9; p<0.01). A trend toward increase in number of normally fertilized embryos (2.9±2.1vs 2.3±1.9; p00.043), and increased prevalence of good quality embryos (51.2% vs 25%; p00.047) were noted. Comparing protocol A and B, there were no significant difference between embryologic data, however there were slight increase in ongoing pregnancy rate in protocol B compared to A (27.1% vs 20%, p00.357), although statistical significance was not achieved. Conclusion Estrogen priming through luteal phase and stimulation phase improved ovarian responsiveness and this may lead to an increase in pregnancy rate in poor responders with failed cycle.

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Section: Discussionmentioning

confidence: 99%

Effect of estrogen priming through luteal phase and stimulation phase in poor responders in in-vitro fertilization

Chang

Han

Won

et al. 2011

J Assist Reprod Genet

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“…In particular, it is interesting that serum E 2 , but not serum FSH, is important as a predictive factor for follicular development, as indicated in the multivariate analysis [26] and our current study. In contrast, it has been reported that POI patients with a FSH level < 15 mIU/mL before treatment can ovulate in response to exogenous gonadotropins [27]. These results collectively suggest that each patient may have an optimal level of serum FSH for follicle growth in each cycle.…”

Section: Outcomes Of Poi Patients For Intermittent Ovarian Activitymentioning

confidence: 82%

Serum estradiol level during withdrawal bleeding as a predictive factor for intermittent ovarian function in women with primary ovarian insufficiency

et al. 2015

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“…It is presumed that chronically elevated gonadotropins levels result in receptor downregulation or desensitization. Suppression of the elevated endogenous gonadotropins using estro-progestins have been found to restore ovarian responsiveness in selected patients with POI [10,14,24], as estrogens may enhance the stimulatory effect of FSH on granulosa-cell FSH receptors as well as FSH binding to its receptors [19]. The down-regulating effect of estro-progestin treatment on ovarian FSH receptor has been found to be time-dependent and dose-dipendent in mice [16], therefore a prolonged estro-progestin treatment could be necessary in case of severe ovarian receptor down-regulation.…”

Section: Discussionmentioning

confidence: 99%

Resumption of ovarian function after 4 years of estro-progestin treatment in a young woman with Crohn’s disease and premature ovarian insufficiency: a case report

Caroppo¹,

D’Amato²

2012

J Assist Reprod Genet

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Purpose To report the long-term management of a case of premature ovarian insufficiency of unknown origin in a young woman with Crohn's disease. Method Here is reported the case of a 20 years old woman with Cronh's disease presenting with two years amenorrhea and FSH and LH levels of 255 mIU/ml and 182 mIU/ml respectively, who received 10 months corticosteroid treatment followed by 7 years of estro-progestin treatment.

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Effects of pretreatment with estrogens on ovarian stimulation with gonadotropins in women with premature ovarian failure: a randomized, placebo-controlled trial

Cited by 103 publications

References 14 publications

Effect of estrogen priming through luteal phase and stimulation phase in poor responders in in-vitro fertilization

Effect of estrogen priming through luteal phase and stimulation phase in poor responders in in-vitro fertilization

Serum estradiol level during withdrawal bleeding as a predictive factor for intermittent ovarian function in women with primary ovarian insufficiency

Resumption of ovarian function after 4 years of estro-progestin treatment in a young woman with Crohn’s disease and premature ovarian insufficiency: a case report

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