Gonadotropin-releasing hormone antagonist versus agonist administration in women undergoing controlled ovarian hyperstimulation: Cycle performance and in vitro steroidogenesis of granulosa-lutein cells

Minaretzis, Demetrios; Alper, Michael M.; Oskowitz, Selwyn P.; Lobel, Susan M.; Mortola, Joseph F.; Pavlou, Spyros N.

doi:10.1016/0002-9378(95)90490-5

Cited by 52 publications

(46 citation statements)

References 17 publications

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“…Using the scoring system, transfer of at least one expanded blastocyst has been demonstrated to result in a significant increase in the implantation and ongoing pregnancy rates (22). All of the ongoing pregnancies achieved in the present study were in women who had received at least one expanded blastocyst, and these results supported the findings by Minaretzis et al (15) and Craft et al (16).…”

Section: Discussionsupporting

confidence: 90%

GnRH Antagonist Improved Blastocyst Quality and Pregnancy Outcome After Multiple Failures of IVF/ICSI–ET with a GnRH Agonist Protocol

Takahashi¹,

Mukaida²,

Tomiyama

et al. 2004

J Assist Reprod Genet

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Background : To determine the efficacy of a gonadotrophin-releasing hormone (GnRH) antagonist, cetrorelix, in improving the quality of embryos and pregnancy outcome, we performed a study in patients with a history of multiple failures of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles with a GnRH agonist (GnRHa) long protocol. Methods : Forty women with no live births after conventional IVF or ICSI embryo transfer (ET) and subsequent blastocyst transfer (BT) with a GnRHa long protocol entered this study. The treatment protocol consisted of a daily dose of clomiphene citrate 100 mg for 5 days and gonadotrophin injections daily from cycle day 4 onward. Cetrorelix, 0.25 mg/day, was started when the leading follicle reached 14 mm. Induction of ovulation was triggered with human chorionic gonadotrophin (HCG) (N = 36) or GnRHa (N = 4). It was possible to perform BT in 38 patients. Results : Comparison of the results with the results for BT with the previous GnRHa protocol showed no significant differences in number of oocytes retrieved or the zygote-and blastocystdevelopment rate. With the cetrorelix protocol, however, number of patients whose embryos had developed to at least one expanded blastocyst on day 5 was significantly higher than with the GnRHa protocol (25 vs. 9) ( p < 0.001), and 16 of the women became pregnant (42.1%), with 7 delivering 9 infants, 4 ending in abortion (25%), and 5 in progressing. Conclusions : The use of a GnRH antagonist in controlled ovarian hyperstimulation improves the outcome of pregnancy of patients with a history of multiple failure of IVF/ICSI-ET in a GnRHa protocol, most likely due to improvement of the quality of the blastocysts generated.

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Section: Discussionsupporting

confidence: 90%

GnRH Antagonist Improved Blastocyst Quality and Pregnancy Outcome After Multiple Failures of IVF/ICSI–ET with a GnRH Agonist Protocol

Takahashi¹,

Mukaida²,

Tomiyama

et al. 2004

J Assist Reprod Genet

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“…In this study, we did not observe any morphological findings of the oocyte consistent with maturation. A previous report also suggested that GnRH antagonist administration resulted in more mature oocytes and embryos of better quality compared with a GnRH agonist protocol [15]. Eldar-Geva et al reported that a lower IVF embryo transfer success using a GnRH-antagonist/GnRHagonist protocol does not appear to be related to an adverse effect on oocyte quality [16].…”

Section: Discussionmentioning

confidence: 96%

The decrease of serum luteinizing hormone level by a gonadotropin-releasing hormone antagonist following the mild IVF stimulation protocol for IVF and its clinical outcome

Yanaihara

Yorimitsu²,

Motoyama³

et al. 2008

J Assist Reprod Genet

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Purpose While performing the mild ovarian stimulation protocol with a GnRH antagonist, the pregnancy rate was compared between the groups, which were divided by the degree that the luteinizing hormone (LH) level decreased. Materials and methods Patients aged 27 to 42years (36.1 ± 3.79) underwent 308 IVF cycles who opted for IVF via the mild ovarian stimulation protocol began clomiphene citrate on day 3 and recombinant FSH on day 5. A GnRH antagonist was administered when the dominant follicle reached 14mm. Serum LH was measured at the time of GnRH antagonist administration and at the time of hCG injection. The pregnancy rate and implantation rate were compared between 50 cycles in which the LH level dropped less than one-third and the control (LH level within 1/3). Result(s) The pregnancy rate for the group in which the LH level fell less than one third was 18%. Conversely, the pregnancy rate for the control group was 39%. The implantation rate was 18% for the less than one-third group and 26% for the control group. Both the pregnancy rate and the implantation rate for the group in which the LH level fell less than one-third were significantly lower than that of control (p < 0.02). Conslusion(s) When performing the mild ovarian stimulation protocol, serum LH should be followed. If the serum LH level is less than one-third at the time of hCG injection, both the pregnancy rate and implantation rate are significantly lower.

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“…In a careful study by Brus et al (22), GnRH receptors have been demonstrated in a large proportion of follicular aspirates containing granulosa lutein cells but not in preovulatory follicles, suggesting that GnRH receptors are present in human ovarian tissue predominantly after the LH surge. The expression of the GnRH receptor gene in the human ovary has been shown by several groups (3,16,17,28). GnRH receptor gene expression is up-regulated by GnRH, but down-regulated by hCG (17).…”

Section: Discussionmentioning

confidence: 98%

“…Studies on the actions of GnRH analogues on steroidogenesis in granulosa lutein cells in vitro revealed contradictory effects (17, 23±27). Minimal information is available on the actions of GnRH antagonists in the human ovary (3). Since GnRH antagonists will be more widely used in protocols of COH in the near future it is important to characterize their ovarian effects, which might be advantageous or detrimental for the treatment goal.…”

Section: Introductionmentioning

confidence: 99%

Actions of gonadotropin-releasing hormone antagonists on steroidogenesis in human granulosa lutein cells

Weiß

Oltmanns

Gürke

et al. 2001

European Journal of Endocrinology

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Objective: GnRH antagonists have recently been introduced for the prevention of premature LH surges during controlled ovarian hyperstimulation (COH). We have here investigated whether the GnRH antagonists cetrorelix and ganirelix exert effects on ovarian steroidogenesis. Since there is some controversy about the action of GnRH agonists in the human ovary we also tested the effect of triptorelin on steroid production in cultured human granulosa lutein cells.

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Gonadotropin-releasing hormone antagonist versus agonist administration in women undergoing controlled ovarian hyperstimulation: Cycle performance and in vitro steroidogenesis of granulosa-lutein cells

Cited by 52 publications

References 17 publications

GnRH Antagonist Improved Blastocyst Quality and Pregnancy Outcome After Multiple Failures of IVF/ICSI–ET with a GnRH Agonist Protocol

GnRH Antagonist Improved Blastocyst Quality and Pregnancy Outcome After Multiple Failures of IVF/ICSI–ET with a GnRH Agonist Protocol

The decrease of serum luteinizing hormone level by a gonadotropin-releasing hormone antagonist following the mild IVF stimulation protocol for IVF and its clinical outcome

Actions of gonadotropin-releasing hormone antagonists on steroidogenesis in human granulosa lutein cells

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