Induction of Ovulation for in-Vitro Fertilisation Using Buserelin and Gonadotropins

Porter, Robert H.; Smith, William I.; Craft, Ian; Abdulwahid, N. A.; Jacobs, H. S.

doi:10.1016/s0140-6736(84)92840-x

Cited by 364 publications

(128 citation statements)

References 2 publications

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“…In 1980, pulsatile low-dose GnRH1a was used in a physiological manner to produce the first reported pregnancy in a woman with hypogonadotrophic hypogonadism (8). Through the early 1980s, GnRH1a was applied to prevent the LH surge during ovarian stimulation (9). By the end of the decade, the so-called long downregulation protocol with GnRH1a was established IVF practice, significantly reducing the rate of cycle cancellation, improving outcomes and enabling some flexibility to schedule oocyte retrieval (10).…”

Section: Historical Perspectivementioning

confidence: 99%

GnRH analogues: applications in assisted reproductive techniques

Hayden

2008

European Journal of Endocrinology

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The ability to prevent an endogenous LH surge revolutionised the efficacy of assisted reproductive techniques (ART) such that GnRH agonists were rapidly adopted in the 1980s. Prior to this, premature luteinisation occurred in up to 25% of superovulated cycles leading to cycle cancellation and severely compromised outcomes. Analogues have been applied in a variety of drug protocols (long, short flare) but there has been little research to moderate the degree of pituitary suppression. There has also been ongoing and unresolved debate about the role of LH in supporting follicular development.By 2001, the first GnRH antagonists were registered for use in ART. Their ability to cause immediate suppression of gonadotrophin (particularly LH) secretion means that they can be given after exogenous stimulation has begun and thereby dramatically shorten the total duration of a treatment cycle. After initial enthusiasm and then scepticism that pregnancy rates may not be as high as the established agonist regimens, these preparations are now being increasingly adopted with at least comparable outcomes in large trials. They are certainly favoured by patients for their reduced side-effect profile and particularly for the shortening of the total cycle length. This shift in practice is occurring alongside gathering momentum in favour of milder stimulation protocols and a new perception of what constitutes successful treatment. The focus is moving away from surrogate outcomes such as oocyte numbers and conception rates towards long-term outcomes for women and their offspring, namely the achievement of a live singleton birth per treatment started.

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Section: Historical Perspectivementioning

confidence: 99%

GnRH analogues: applications in assisted reproductive techniques

Hayden

2008

European Journal of Endocrinology

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“…There is a marked increase in survival, reduction in prostate-specific antigen (PSA) and pain. GnRH analogues are also employed in almost all cycles for IVF treatment to avoid the spontaneous LH surge and loss of oocytes before laproscopic surgery for oocyte retrieval 66 . In all other applications of GnRH analogues, alternative therapeutic approaches are available (for details the reader is referred to a review 67 ).…”

Section: Therapeutic Applications Of Gnrh Analoguesmentioning

confidence: 99%

Current and future applications of GnRH, kisspeptin and neurokinin B analogues

Millar

Newton

2013

Nat Rev Endocrinol

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Reproductive hormones impact on all stages of life from gamete production, fertilisation, fetal development and parturition, neonatal development and puberty through to adulthood and senescence.The reproductive hormone cascade has therefore been the target for the development of numerous drugs which modulate its activity at many levels. As the central regulator of the cascade, gonadotropinreleasing hormone (GnRH) agonists and antagonists have found extensive applications in treating a wide range of hormone-dependent deseases such as precocious puberty, prostate cancer, benign prostatic hyperplasia, endometriosis and uterine fibroids, as well as being an essential component of in vitro fertilisation (IVF) protocols. Recently-discovered neuroendocrine peptides, kisspeptin (KP) and neurokinin B (NKB), have also been identified as therapeutic targets and novel agonists and antagonists are being developed as modulators of the cascade upstream of GnRH. Here we review the development and applications of analogues of the major neuroendocrine peptide regulators of the reproductive hormone cascade, GnRH, KP and NKB.

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“…Women 18 to 38 years of age were included if they fulfilled the following criteria: [1] infertility attributable to tubal factor, male factor, or unexplained infertility; [2] serum levels of FSH, LH, and prolactin in the normal range; [3] regular ovulatory menstrual cycles of 25 to 35 days; [4] a normal uterine cavity; [5] no treatment with gonadotropins in the month before study entry; [6] presentation for the first IVF treatment cycle; [7] body mass index Ն18 but Յ26 kg/m 2 ; and [8] willingness to participate in the study and to comply with the procedures.…”

Section: Patient Selectionmentioning

confidence: 99%

“…Ovarian stimulation regimens generally include pituitary desensitization (down-regulation) with a GnRH analogue followed by administration of gonadotropins (2). Pituitary down-regulation with GnRH agonist, which inhibits the mid-cycle LH surge, is one of the most effective ways to induce formation of enough preovulatory follicles (3)(4)(5).…”

mentioning

confidence: 99%

Effect of highly purified urinary follicle-stimulating hormone on oocyte and embryo quality

Selman¹,

Santo²,

Sterzik³

et al. 2002

Fertility and Sterility

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Objective:To determine the effects of ovarian stimulation with highly purified urofollitropin on oocyte and embryo quality. Main Outcome Measure(s):Primary end points were number of morphologically mature oocytes retrieved, embryo quality, and pregnancy and implantation rates. Secondary end points were: total number of days of FSH stimulation, total dose of gonadotropin administered, fertilization rate per number of retrieved oocytes, embryo cleavage rate, live birth and miscarriage rates, endometrial thickness and estradiol level on the day of hCG administration, cancellation rate, and incidence of moderate or severe ovarian hyperstimulation syndrome. Result(s): Pregnancy and implantation rates were nonsignificantly higher in the urinary FSH group than the recombinant FSH group (46.5% vs. 36.8% and 22.1% vs. 15.8%, respectively). The grade 1 embryo score was significantly higher in the urinary FSH group than the recombinant FSH (42.1% vs. 33.5%), and the live birth rate was nonsignificantly higher in the former group. Conclusion(s):Highly purified urinary FSH is as effective, efficient, and safe for clinical use as recombinant FSH. (Fertil Steril 2002;78:1061-7.

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Induction of Ovulation for in-Vitro Fertilisation Using Buserelin and Gonadotropins

Cited by 364 publications

References 2 publications

GnRH analogues: applications in assisted reproductive techniques

GnRH analogues: applications in assisted reproductive techniques

Current and future applications of GnRH, kisspeptin and neurokinin B analogues

Effect of highly purified urinary follicle-stimulating hormone on oocyte and embryo quality

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