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Early initiation of gonadotropin-releasing hormone antagonist treatment results in a more stable endocrine milieu during the mid- and late-follicular phases: a randomized controlled trial comparing gonadotropin-releasing hormone antagonist initiation on cycle day 2 or 6.
Fertil Steril. 2013 Sep; 100(3):867-74.FS

Abstract

OBJECTIVE

To compare the effect of initiating GnRH antagonist (GnRH-a) on cycle day (CD) 2 vs. CD 6 on LH, E₂, and P levels in the mid and late follicular phases.

DESIGN

Nested study within a multicenter randomized controlled trial.

SETTING

Reproductive medicine center in an university hospital.

PATIENT(S)

One hundred sixty patients undergoing IVF/intracytoplasmic sperm injection (ICSI).

INTERVENTION(S)

Recombinant FSH (150-225 IU) was administered daily from CD 2 onward. The study group (CD 2) started GnRH-a cotreatment on CD 2, whereas the control group (CD 6) started on CD 6.

MAIN OUTCOME MEASURE(S)

The follicular phase endocrine profile.

RESULT(S)

The LH levels on CD 6 were lower in the CD 2 group (0.6 ± 0.4 vs. 1.9 ± 1.4 IU/L). The CD 2 group demonstrated both lower E₂ levels on CD 6 (520.1 ± 429.6 pmol/L vs. 1,071.7 ± 654.2 pmol/L) and on the day of hCG administration (3,341.4 ± 1,535.3 pmol/L vs. 4,573.2 ± 2,445.4 pmol/L). The P levels did not differ on CD 6 or on the day of hCG administration.

CONCLUSION(S)

Early initiation of GnRH-a cotreatment results in a more stable endocrine profile, with more physiological levels of E2 and LH during the follicular phase. The effect on clinical outcomes must be established in larger trials.

CLINICAL TRIAL REGISTRATION NUMBER

NCT00866034.

Authors+Show Affiliations

Department of Reproductive Medicine and Gynecology University Medical Centre Utrecht, Utrecht, the Netherlands. O.Hamdine@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23809501

Citation

Hamdine, Ouijdane, et al. "Early Initiation of Gonadotropin-releasing Hormone Antagonist Treatment Results in a More Stable Endocrine Milieu During the Mid- and Late-follicular Phases: a Randomized Controlled Trial Comparing Gonadotropin-releasing Hormone Antagonist Initiation On Cycle Day 2 or 6." Fertility and Sterility, vol. 100, no. 3, 2013, pp. 867-74.
Hamdine O, Broekmans FJ, Eijkemans MJ, et al. Early initiation of gonadotropin-releasing hormone antagonist treatment results in a more stable endocrine milieu during the mid- and late-follicular phases: a randomized controlled trial comparing gonadotropin-releasing hormone antagonist initiation on cycle day 2 or 6. Fertil Steril. 2013;100(3):867-74.
Hamdine, O., Broekmans, F. J., Eijkemans, M. J., Lambalk, C. B., Fauser, B. C., Laven, J. S., & Macklon, N. S. (2013). Early initiation of gonadotropin-releasing hormone antagonist treatment results in a more stable endocrine milieu during the mid- and late-follicular phases: a randomized controlled trial comparing gonadotropin-releasing hormone antagonist initiation on cycle day 2 or 6. Fertility and Sterility, 100(3), 867-74. https://doi.org/10.1016/j.fertnstert.2013.05.031
Hamdine O, et al. Early Initiation of Gonadotropin-releasing Hormone Antagonist Treatment Results in a More Stable Endocrine Milieu During the Mid- and Late-follicular Phases: a Randomized Controlled Trial Comparing Gonadotropin-releasing Hormone Antagonist Initiation On Cycle Day 2 or 6. Fertil Steril. 2013;100(3):867-74. PubMed PMID: 23809501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early initiation of gonadotropin-releasing hormone antagonist treatment results in a more stable endocrine milieu during the mid- and late-follicular phases: a randomized controlled trial comparing gonadotropin-releasing hormone antagonist initiation on cycle day 2 or 6. AU - Hamdine,Ouijdane, AU - Broekmans,Frank J, AU - Eijkemans,Marinus J C, AU - Lambalk,Cornelis B, AU - Fauser,Bart C J M, AU - Laven,Joop S E, AU - Macklon,Nick S, AU - ,, Y1 - 2013/06/27/ PY - 2013/03/17/received PY - 2013/05/20/revised PY - 2013/05/21/accepted PY - 2013/7/2/entrez PY - 2013/7/3/pubmed PY - 2013/12/16/medline KW - GnRH antagonist KW - IVF KW - LH KW - estradiol KW - progesterone SP - 867 EP - 74 JF - Fertility and sterility JO - Fertil. Steril. VL - 100 IS - 3 N2 - OBJECTIVE: To compare the effect of initiating GnRH antagonist (GnRH-a) on cycle day (CD) 2 vs. CD 6 on LH, E₂, and P levels in the mid and late follicular phases. DESIGN: Nested study within a multicenter randomized controlled trial. SETTING: Reproductive medicine center in an university hospital. PATIENT(S): One hundred sixty patients undergoing IVF/intracytoplasmic sperm injection (ICSI). INTERVENTION(S): Recombinant FSH (150-225 IU) was administered daily from CD 2 onward. The study group (CD 2) started GnRH-a cotreatment on CD 2, whereas the control group (CD 6) started on CD 6. MAIN OUTCOME MEASURE(S): The follicular phase endocrine profile. RESULT(S): The LH levels on CD 6 were lower in the CD 2 group (0.6 ± 0.4 vs. 1.9 ± 1.4 IU/L). The CD 2 group demonstrated both lower E₂ levels on CD 6 (520.1 ± 429.6 pmol/L vs. 1,071.7 ± 654.2 pmol/L) and on the day of hCG administration (3,341.4 ± 1,535.3 pmol/L vs. 4,573.2 ± 2,445.4 pmol/L). The P levels did not differ on CD 6 or on the day of hCG administration. CONCLUSION(S): Early initiation of GnRH-a cotreatment results in a more stable endocrine profile, with more physiological levels of E2 and LH during the follicular phase. The effect on clinical outcomes must be established in larger trials. CLINICAL TRIAL REGISTRATION NUMBER: NCT00866034. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/23809501/Early_initiation_of_gonadotropin_releasing_hormone_antagonist_treatment_results_in_a_more_stable_endocrine_milieu_during_the_mid__and_late_follicular_phases:_a_randomized_controlled_trial_comparing_gonadotropin_releasing_hormone_antagonist_initiation_on_cycle_day_2_or_6_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(13)00641-9 DB - PRIME DP - Unbound Medicine ER -