Ovarian cyst formation: a complication of gonadotropin-releasing hormone agonist therapy

Feldberg, Dov; Ashkenazi, Jacob; Dicker, Dov; Yeshaya, Arie; Goldman, Gideon; Goldman, Jack A.

doi:10.1016/s0015-0282(16)60425-9

Cited by 62 publications

(20 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The incidence varies between 5.5% and 53% in different studies (1,4,5,8,12 ). In a recent study performed by Qublan et al (4), the rate was reported as 9.3% in a large population of IVF patients, which was consistent with our results, at 8.3%.…”

Section: Discussionsupporting

confidence: 92%

“…The impressive transient flare-up effect of GnRH-a on immature antral follicles with LH surge inhibition has been the most frequent explanation (5)(6)(7)(8). The presence of an ovarian cyst in IVF cycles has been studied frequently in terms of its effect on the clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Such cysts may impair folliculogenesis in such a way as to decrease the pre-ovulatory follicle numbers and their quality (2,3). In addition to the studies showing the negative effect of the cysts that appear during GnRH-a administration, other studies have concluded that the functional cysts have no effect on the IVF outcome (5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ovarian Cyst Formation Following Gonadotropin-Releasing Hormone-Agonist Administration Decreases the Oocyte Quality in IVF Cycles

Eryılmaz¹,

Sarıkaya²,

Aksakal³

et al. 2012

Balkan Med J

View full text Add to dashboard Cite

Objective: The gonadotropin-releasing hormone-agonist (GnRH-a) treatment during in vitro fertilization (IVF) sometimes causes a functional ovarian cyst during the administration period before gonadotropin stimulation, as an undesired event. The aim of this study was to analyze the effect of these cysts on the IVF outcomes. Materials and Methods:Out of 981 IVF cycles, 78 with ovarian cysts were retrospectively analyzed with respect to the demographic characteristics, hormonal outcomes, and fertilization, implantation and clinical pregnancy rates.Results: The metaphase II oocyte ratio, fertilization rate and percentage of high quality embryos (grade 1) were significantly higher in the cyst-negative group (p<0.0001; p<0.0001; p≤0.05). These same three parameters were also significantly higher in the cyst-aspirated group (p<0.01; p<0.05; p<0.05). Cyst diameters of the aspiration group were significantly higher (p<0.05). No statistically significant differences in implantation and clinical pregnancy rates were determined between the groups.Conclusion: An ovarian cyst formation during the GnRH-a suppression period negatively affects oocyte quality. Cyst aspiration before gonadotropin stimulation does not improve the IVF outcome.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ovarian Cyst Formation Following Gonadotropin-Releasing Hormone-Agonist Administration Decreases the Oocyte Quality in IVF Cycles

Eryılmaz¹,

Sarıkaya²,

Aksakal³

et al. 2012

Balkan Med J

View full text Add to dashboard Cite

show abstract

“…The initiation of ovarian stimulation with gonadotropins in the cases that the follicle cysts have developed depends on the serum E 2 concentrations. When serum E 2 levels are still elevated the initiation of gonadotropins' administration may lead to further enlargement of the cysts and disturbance of the normal follicular development [13]. In our study, when the serum E 2 concentrations were !35 pg/ml, we disregarded the follicle cysts and initiated ovarian stimulation with gonadotropins.…”

Section: Discussionmentioning

confidence: 48%

Evaluation of Ovarian Cysts following GnRH-a Treatment in Patients with Polycystic Ovarian Syndrome

Gregoriou

Vitoratos²,

Konidaris³

et al. 1998

Gynecol Obstet Invest

View full text Add to dashboard Cite

The aim of this study was to evaluate the ovarian cysts appearing during GnRH-a/hMG treatment in patients with polycystic ovarian syndrome (PCOS). A total of 35 women with PCOS were included in the study. All women received 3.75 mg IM of long-acting leuprolide acetate on the first day of the menstrual cycle. On the 15th day of the menstrual cycle, transvaginal ultrasound examination (US) and determination of serum E₂ were done. A total of 90 cycles were studied in this way and during these cycles, 14 (15.5%) ovarian cysts with a diameter of ≥ 20 mm developed. According to the serum E₂ levels, 11 cases (group A) had E₂ concentrations > 35 pg/ml and 3 (group B) had serum E₂ levels < 35 pg/ml. Group A patients attained a significantly larger mean size of ovarian cyst than group B patients (42 ± 7.3 vs. 24.2 ± 3.2 mm, p < 0.001). When the serum E₂ concentrations were < 35 pg/ml, the ovarian cysts were disregarded and ovarian stimulation with gonadotropins was initiated. In case that serum E₂ levels were > 35 pg/ml, the initiation of the ovarian stimulation with hMG was postponed until serum E₂ levels indicated down-regulation, which was achieved after 5.8 ± 2.9 days. In both groups the ovarian stimulation resulted in ovulatory cycles, while four pregnancies in group A and one in group B were achieved. In conclusion, our results indicate that in patients with PCOS the GnRH-a administration may cause follicular cysts at an incidence of 15.5%. These cysts do not constitute a contraindication for ovarian stimulation provided that serum E₂ levels are low.

show abstract

“…In up to 5% of the cases the dose of agonist must be increased or the time needed for suppression prolonged due either to a lack of suppression or secondary to cyst formation [4], Unex pected pregnancies have also occurred in women begin ning medication during the midluteal phase [5], a particu larly worrisome event in the case of oocyte donation.…”

Section: Introductionmentioning

confidence: 99%

Comparing the Clinical Utility of GnRH Antagonist to GnRH Agonist in an Oocyte Donation Program

Sauer¹,

Paulson²,

Løbo³

1997

Gynecol Obstet Invest

View full text Add to dashboard Cite

A potent gonadotropin-releasing hormone (GnRH) antagonist (Nal-Glu) was administered to downregulate the pituitaries of oocyte donors (n = 15) and block their midcycle luteinizing hormone surges. Donors received Nal-Glu at a dose of 50 µg/kg/day i.m., beginning when lead follicles reached a mean diameter of 14 mm. All donors had previously undergone controlled ovarian hyperstimulation cycles using GnRH agonist (leuprolide acetate) administered subcutaneously beginning during the midluteal phase. Ovarian stimulation was performed using human menopausal gonadotropin (hMG). Compared to previous stimulated cycles using agonist and hMG, cycles with antagonist and hMG demonstrated a significant decrease in the amount of hMG required for follicle stimulation (24.7 ± 1.8 vs. 31.3 ± 2.5 ampules; p < 0.05). There was also a significant reduction in the number of patient visits necessary per cycle (5.1 ± 1.4 vs. 9.3 ± 1.1; p < 0.05) and the required duration of treatment to accomplish a cycle (27.1 ± 5.3 vs. 11.3 ± 1.3 days; p < 0.05). However, there were no differences noted in the number of oocytes retrieved (10.7 ± 4.5 vs. 13.0 ± 6.3), the fertilization rate of oocytes (60.3 ± 10.2 vs. 53.9 ± 11.6%), or the number of embryos obtained per recipient (5.5 ± 3.2 vs. 7.6 ± 5.3). Clinical pregnancies occurred in 7 of 15 transfer cycles to recipients. There were no serious adverse side effects experienced by donors using antagonist. We conclude that the use of GnRH antagonist significantly reduces the amount of medication and the time required for ovarian hyperstimulation and that is a useful adjunct in cycling oocyte donors.

show abstract

Ovarian cyst formation: a complication of gonadotropin-releasing hormone agonist therapy

Cited by 62 publications

References 8 publications

Ovarian Cyst Formation Following Gonadotropin-Releasing Hormone-Agonist Administration Decreases the Oocyte Quality in IVF Cycles

Ovarian Cyst Formation Following Gonadotropin-Releasing Hormone-Agonist Administration Decreases the Oocyte Quality in IVF Cycles

Evaluation of Ovarian Cysts following GnRH-a Treatment in Patients with Polycystic Ovarian Syndrome

Comparing the Clinical Utility of GnRH Antagonist to GnRH Agonist in an Oocyte Donation Program

Contact Info

Product

Resources

About