Endocrinology: Luteal function following ovulation induction in polycystic ovary syndrome patients using exogenous gonadotrophins in combination with a gonadotrophin-releasing hormone agonist |
| |
Authors: | Donderwinkel PFJ; Schoot DC; Pache TD; de Jong FH; Hop WCJ; Fauser BCJM |
| |
Institution: | 1Department of Medicine III Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
2Department of Epidemiology and Biostatistics, Dijkzigt University Hospital and Erasmus University Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands |
| |
Abstract: | The luteal phase was studied in 12 polycystic ovary syndrome(PCOS) patients following ovulation induction using exogenousgonadotrophins combined with a gonadotrophin-releasing hormoneagonist (GnRH-a). Human menopausal gonadotrophin (HMG) was precededby 3 weeks of treatment with GnRH-a (buserelin; 1200 µg/dayintra-nasally) and administered in a step-down dose regimenstarting with 225 IU/day i.m. GnRH-a was withheld the day beforeadministration of human chorionic gonadotrophin (HCG; 10 000IU i.m.). Blood sampling and ultrasound monitoring was performedevery 23 days until menses. The luteal phase was significantlyshorter in PCOS patients as compared to eight regularly cyclingcontrols: 8.8 (3.311.4) days median(range)] versus 12.8(8.915.9) days (P = 0.01). Median peak values for progesteronedid not show significant differences comparing both groups:52.3 (17.1510.3) nmol/l versus 43.0 (31.271.1)nmol/l, respectively (P = 0.8). The interval between the dayof the progesterone peak and return to baseline was significantlyshorter in the PCOS patients than in controls: 2.5 (0.34.9)days versus 4.2 (3.910.5) days (P < 0.005). Luteinizinghormone (LH) concentrations during the luteal phase as reflectedby area under the curve were significantly lower in PCOS ascompared to controls: 4.4 (1.621.0) IU/l x days and 49.0(27.879.6) IU/l x days, respectively (P < 0.001).In conclusion, patients with PCOS may suffer from insufficientluteal phases after ovulation induction using HMG/HCG in combinationwith a GnRH-a. The corpus luteum apparently lacks the supportof endogenous LH and may be stimulated only by the pre-ovulatoryinjection of HCG. Potential involvement of adjuvant GnRH-a medicationor HCG itself in luteal suppression of endogenous gonadotrophinsecretion, and the importance of luteal function for pregnancyrates following treatment, warrant further studies. |
| |
Keywords: | exogenous gonadotrophins/GnRH-a/luteal function/ovulation induction/polycystic ovary syndrome |
本文献已被 Oxford 等数据库收录! |
|