Flexible protocol for administration of human follicle-stimulating hormone with gonadotropin-releasing hormone antagonist.

OBJECTIVE: To test, using a primate model, a new approach for achieving individualized pituitary-ovarian responses to controlled ovarian hyperstimulation. DESIGN: Normal ovulatory adult monkeys were selected and randomly assigned to one of the three groups according to onset of spontaneous menses. They had no prior exposure to gonadotropin-releasing hormone (GnRH) antagonist or exogenous gonadotropin therapies. SETTING: The laboratories of The Jones Institute for Reproductive Medicine were used. PATIENTS, PARTICIPANTS: Normal adult macaque females were studied. INTERVENTIONS: Monkeys received hormonal therapies of gonadotropins in combination with GnRH antagonist. MAIN OUTCOME MEASURE(S): Pituitary luteinizing hormone (LH) secretion and ovarian estrogen and progesterone production were monitored. RESULTS: Adding GnRH antagonist to ongoing human follicle-stimulating hormone (hFSH) stimulation can prevent unwanted LH surges, whether begun at early, mid, or late points in the stimulation protocol. CONCLUSIONS: The flexible protocol for administration of hFSH with GnRH antagonist yielded satisfactory results, with apparent advantages of economy, convenience, and individuality of treatment compared with GnRH agonist plus gonadotropin regimens used currently.