Synchronization of endogenous and exogenous FSH stimuli in controlled ovarian hyperstimulation (COH) |
| |
Authors: | de Ziegler D; Jaaskelainen AS; Brioschi PA; Fanchin R; Bulletti C |
| |
Institution: | Department of OB/GYN, Hospital of Nyon, Switzerland. |
| |
Abstract: | We have previously observed that exogenous oestradiol can delay the
intercycle increase in plasma follicle stimulating hormone (FSH). The
increase in plasma FSH that follows discontinuation of exogenous oestradiol
peaks after 3 days. We have now studied the possibility of using exogenous
oestradiol to synchronize the increase in endogenous FSH with the onset of
human menopausal gonadotrophin (HMG) treatment in controlled ovarian
hyperstimulation (COH). A total of 30 women aged 35.1+/-6.3 years
(mean+/-SD) undergoing ovarian stimulation received 2 mg of oestradiol
valerate twice daily starting on day 25 of the previous menstrual cycle
until the first Tuesday following menses. Ovarian stimulation was initiated
3 days later. On the last day of oestradiol treatment, plasma oestradiol,
FSH and luteinizing hormone (LH) (mean+/-SEM) were 566+/-53 (pmol/l),
3.8+/-0.4 (IU/l) and 5.5+/- 0.8 (IU/l) respectively. After 3 days, the FSH
and LH (mean+/-SEM) had increased to 6.7+/-0.7 and 6.9+/-0.7 (IU/l)
respectively while oestradiol decreased to 251+/-29 (pmol/l). The mean
number (+/-SEM) of HMG ampoules used was 25.1+/-2.7 and treatment lasted
11.3+/-0.9 days. Five women became pregnant for a pregnancy rate (ongoing)
of 19 (15)%. If all women aged >40 years (six women who did not become
pregnant) were excluded from analysis the pregnancy rate (ongoing) was 24
(19%). These results indicate that exogenous oestradiol can safely be used
for the synchronization of endogenous and exogenous FSH stimuli in COH.
This approach provides the practical advantage of permitting an advanced
timing of the onset of COH treatments when gonadotrophin- releasing hormone
(GnRH) agonists are not used, which improves treatment convenience for
patients and team members alike. Further development of this model may
enable control of the onset of natural cycles which may find practical
applications for timing assisted reproductive techniques (intrauterine
insemination or in-vitro fertilization) in the natural cycle.
|
| |
Keywords: | |
本文献已被 Oxford 等数据库收录! |
|