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Effect of gonadotrophin-releasing hormone (GnRH) antagonist during the LH surge in normal women and during controlled ovarian hyperstimulation.
Clin Endocrinol (Oxf) 2000; 52(6):721-6CE

Abstract

OBJECTIVE

Several studies have suggested that GnRH is instrumental in triggering the LH surge. The present studies were performed to evaluate the effect of GnRH antagonist administration in women after the beginning of the LH surge.

DESIGN

In study one, six normal cycling women were given a GnRH antagonist (20 mg Nal Glu s.c.) during an unstimulated cycle. Nal-Glu was administered when the LH level was higher than 10 U/l and associated with an oestradiol (E2) level higher than 730 pmol/l. In study two, a GnRH antagonist (3 mg Cetrorelix, ASTA-Medica, Frankfurt, Germany) was administered on day 8 of an IVF-ET cycle, in 157 women. Eighteen women among this cohort received the antagonist, when their LH level was higher than 10 U/l.

RESULTS

In normal volunteers (study one), Nal-Glu was administered on day 13.7 +/- 1.4 (mean +/- SD) of the cycle when the LH level was 13.7 +/- 3.5 U/l with an E2 plasma level reaching 980 +/- 131 pmol/l. Twenty-four hours after administration of the antagonist, the LH surge had been interrupted in all subjects; it was postponed in three of the women, and abolished in the remaining three. LH levels fell by 68.5%, E2 by 42% and FSH by 53.2%. In study two, LH plasma levels 24 h after the antagonist administration fell by 94%. No premature ovulation occurred in any of the patients treated. Administering the antagonist before (n = 139) or during the LH surge (n = 18) made no statistically significant difference to the results of the IVF-ET attempt.

CONCLUSIONS

Our results indicate that GnRH is required throughout the gonadotrophin surge in women, not only for the initiation but also for the maintenance of the LH surge. In addition, in our study, the suppression of the rise in LH, when the antagonist was given during the surge, had no detrimental impact on IVF-ET outcome. This suggests, if confirmed on a larger scale, that late follicular phase GnRH antagonist administration to prevent the LH surge in controlled ovarian hyperstimulation (COH) is a safe and useful treatment.

Authors+Show Affiliations

Service d'Endocrinologie Hôpital Saint-Antoine, Paris, France. sophie.christin-maitre@sat.ap-hop-paris.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

10848876

Citation

Christin-Maitre, S, et al. "Effect of Gonadotrophin-releasing Hormone (GnRH) Antagonist During the LH Surge in Normal Women and During Controlled Ovarian Hyperstimulation." Clinical Endocrinology, vol. 52, no. 6, 2000, pp. 721-6.
Christin-Maitre S, Olivennes F, Dubourdieu S, et al. Effect of gonadotrophin-releasing hormone (GnRH) antagonist during the LH surge in normal women and during controlled ovarian hyperstimulation. Clin Endocrinol (Oxf). 2000;52(6):721-6.
Christin-Maitre, S., Olivennes, F., Dubourdieu, S., Chabbert-Buffet, N., Charbonnel, B., Frydman, R., & Bouchard, P. (2000). Effect of gonadotrophin-releasing hormone (GnRH) antagonist during the LH surge in normal women and during controlled ovarian hyperstimulation. Clinical Endocrinology, 52(6), pp. 721-6.
Christin-Maitre S, et al. Effect of Gonadotrophin-releasing Hormone (GnRH) Antagonist During the LH Surge in Normal Women and During Controlled Ovarian Hyperstimulation. Clin Endocrinol (Oxf). 2000;52(6):721-6. PubMed PMID: 10848876.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of gonadotrophin-releasing hormone (GnRH) antagonist during the LH surge in normal women and during controlled ovarian hyperstimulation. AU - Christin-Maitre,S, AU - Olivennes,F, AU - Dubourdieu,S, AU - Chabbert-Buffet,N, AU - Charbonnel,B, AU - Frydman,R, AU - Bouchard,P, PY - 2000/6/10/pubmed PY - 2000/8/6/medline PY - 2000/6/10/entrez SP - 721 EP - 6 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 52 IS - 6 N2 - OBJECTIVE: Several studies have suggested that GnRH is instrumental in triggering the LH surge. The present studies were performed to evaluate the effect of GnRH antagonist administration in women after the beginning of the LH surge. DESIGN: In study one, six normal cycling women were given a GnRH antagonist (20 mg Nal Glu s.c.) during an unstimulated cycle. Nal-Glu was administered when the LH level was higher than 10 U/l and associated with an oestradiol (E2) level higher than 730 pmol/l. In study two, a GnRH antagonist (3 mg Cetrorelix, ASTA-Medica, Frankfurt, Germany) was administered on day 8 of an IVF-ET cycle, in 157 women. Eighteen women among this cohort received the antagonist, when their LH level was higher than 10 U/l. RESULTS: In normal volunteers (study one), Nal-Glu was administered on day 13.7 +/- 1.4 (mean +/- SD) of the cycle when the LH level was 13.7 +/- 3.5 U/l with an E2 plasma level reaching 980 +/- 131 pmol/l. Twenty-four hours after administration of the antagonist, the LH surge had been interrupted in all subjects; it was postponed in three of the women, and abolished in the remaining three. LH levels fell by 68.5%, E2 by 42% and FSH by 53.2%. In study two, LH plasma levels 24 h after the antagonist administration fell by 94%. No premature ovulation occurred in any of the patients treated. Administering the antagonist before (n = 139) or during the LH surge (n = 18) made no statistically significant difference to the results of the IVF-ET attempt. CONCLUSIONS: Our results indicate that GnRH is required throughout the gonadotrophin surge in women, not only for the initiation but also for the maintenance of the LH surge. In addition, in our study, the suppression of the rise in LH, when the antagonist was given during the surge, had no detrimental impact on IVF-ET outcome. This suggests, if confirmed on a larger scale, that late follicular phase GnRH antagonist administration to prevent the LH surge in controlled ovarian hyperstimulation (COH) is a safe and useful treatment. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/10848876/Effect_of_gonadotrophin_releasing_hormone__GnRH__antagonist_during_the_LH_surge_in_normal_women_and_during_controlled_ovarian_hyperstimulation_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0300-0664&date=2000&volume=52&issue=6&spage=721 DB - PRIME DP - Unbound Medicine ER -