Gonadotropin responsiveness to ultralow-dose leuprolide acetate administration in baboons

Scott, Richard T.; Carey, K. Dee; Leland, M. Michelle; Navot, Daniel

doi:10.1016/s0015-0282(16)55939-1

Cited by 21 publications

(5 citation statements)

References 9 publications

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“…The basic hypothesis of this approach is to administer the minimal dose of GnRHa necessary to induce gonadotropin release while minimizing premature ovulation. Leuprolide acetate doses as low as 25 mcg in humans and 0.017 mcg/kg in baboons administered in the early follicular phase were sufficient to induce increases in circulating gonadotropin levels [24,25]. However, the minimum dose necessary to induce this effect has not been established.…”

Section: Gnrha: Microdose Flare Regimesmentioning

confidence: 99%

Management of the poor responder: the role of GnRH agonists and antagonists

Surrey

2007

J Assist Reprod Genet

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There is no one controlled ovarian hyperstimulation (COH) protocol which is best suited for all poor responders. Low dose GnRHa regimes appear to be most advantageous. Prediction of compromised response prior to cycle initiation by a thorough assessment of ovarian reserve as well as a careful review of past response should allow for selection of an appropriate COH protocol for each individual patient.

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Section: Gnrha: Microdose Flare Regimesmentioning

confidence: 99%

Management of the poor responder: the role of GnRH agonists and antagonists

Surrey

2007

J Assist Reprod Genet

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“…However, the magnitude and duration of gonadotropin rise in response to low-dose GnRH-a without exogenous gonadotropins has not been reported. Animal studies have demonstrated that very low doses of GnRH-a in the absence of supplemental exogenous gonadotropins achieve FSH levels that surpass the threshold required to achieve multiple follicle growth (11). In this study, we hypothesized that low doses of GnRH-a administered alone in the early follicular phase would result in an increase in gonadotropin levels that could induce multiple follicle development among normal responders.…”

mentioning

confidence: 97%

Microdose gonadotropin-releasing hormone agonist in the absence of exogenous gonadotropins is not sufficient to induce multiple follicle development

Chung

Fogle

Bendikson

et al. 2011

Fertility and Sterility

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“…Usually GnRHa firstly induces an augmented pituitary response (flare up effect) followed by gradually pituitary down regulation [5,6]. There was successful report in animal study that taking advantage of the initial flare-up effect and using ultra-low dose of short-acting GnRHa to achieve multiple follicles development without exogenous gonadotropines, it suggested that GnRHa alone could generate enough FSH level and duration for multiple follicles recruitment [7]. But recent study in human [8] demonstrated that microdose GnRHa alone is not sufficient to induce multiple follicles development.…”

Section: Discussionmentioning

confidence: 99%

A case report: successful pregnancy after controlled ovarian hyperstimulation by using short-acting gonadotropin releasing hormone agonist only

Gong

Cai

Zhang

et al. 2012

J Assist Reprod Genet

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Controlled ovarian hyperstimulation (COH) is widely used in in vitro fertilization and embryo transfer (IVF-ET) to achieve multiple follicle development during one treatment cycle. COH is usually initiated by gonadotropin releasing hormone agonist (GnRHa) to down-regulate pituitary secretion of gonadotropins, suppress endogenous LH surge and synchronize multiple follicles development, which is followed by stepwise exogenous gonadotropins stimulation [1,2]. Here we report a case of successful pregnancy after inducing multiple follicles development by using short-acting GnRHa only.A 31-year-old woman, 50 kg weight, was administrated in our unit for four-year primary infertility. Her menstrual cycle was 28 days, lasting 6-7 days. The basal serum follicle-stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) level was 5.1 mIU/mL, 3.56 mIU/mL, and 38.81 pg/mL, respectively. The numbers of antral follicles were eight per ovary.In the mid-luteal phase, the patient was administrated of short-acting GnRHa (Decapeptyl, Ferring, Germany) 0.1 mg/day for pituitary down-regulation] to initiate an IVF treatment cycle. After 14 days administration, the serum FSH was 4.58 mIU/mL, LH was 29.23 mIU/mL, and E2 was 26.79 pg/mL. Transvaginal ultrasound examination showed that there were five follicles with average diameter more than 10 mm, and the largest one was 14 mm. 0.1 mg Decapeptyl was continuously given for one more day and the LH level maintained 29.96 mIU/mL. Then, we decreased the dose of GnRHa to 0.05 mg/day and continuously given for four more days. Ultrasound examination showed five follicles with average diameter more than 20 mm, the largest one was 28 mm. The patients' serum E2 increased to 1,270 pg/mL, LH was 13.51 mIU/mL. 0.05 mg Decapeptyl was continuously given in the morning and 10,000 IU human chorionic gonadotropin (hCG) was administered to trigger egg maturation in the evening. The patient was scheduled for oocyte retrieval 34 h after the hCG injection. Five oocytes were obtained and three fertilized successfully. Two grade I embryos at the 8-cell stage were transferred at d3, and a surplus grade I embryos at the 7-cell stage were frozen. Routine luteum support (UTROGESTAN 200 mg, Bid, Laboratoires Besins-Iscovesco, France) was given after embryo transfer (ET). Serum β-hCG level examined 14 days after ET was 613.9 mIU/mL, indicating a successful biochemical pregnancy. A transvaginal ultrasound examination 4 months after ET confirmed an ongoing intrauterine twin pregnancy. DiscussionIt is widely accepted that high serum LH level in follicular phase will affect the quality of oocytes and ultimately compromise the IVF outcome [3,4], therefore Porter in 1984 [1] firstly introduced the GnRHa into COH to suppress endogenous LH surge. Usually GnRHa firstly induces an augmented pituitary response (flare up effect) followed by

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Gonadotropin responsiveness to ultralow-dose leuprolide acetate administration in baboons

Cited by 21 publications

References 9 publications

Management of the poor responder: the role of GnRH agonists and antagonists

Management of the poor responder: the role of GnRH agonists and antagonists

Microdose gonadotropin-releasing hormone agonist in the absence of exogenous gonadotropins is not sufficient to induce multiple follicle development

A case report: successful pregnancy after controlled ovarian hyperstimulation by using short-acting gonadotropin releasing hormone agonist only

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