Stop GnRH-Agonist Combined with Multiple-Dose GnRH-Antagonist for Patients with Elevated Peak Serum Progesterone Levels Undergoing Ovarian Stimulation for IVF: A Proof of Concept.
Adult
Clinical Protocols
Female
Fertilization in Vitro
/ methods
Follicular Phase
/ blood
Gonadotropin-Releasing Hormone
/ antagonists & inhibitors
Hormone Antagonists
/ administration & dosage
Humans
Ovulation Induction
/ methods
Pregnancy
Pregnancy Rate
Progesterone
/ blood
Proof of Concept Study
Prospective Studies
Sperm Injections, Intracytoplasmic
/ methods
Treatment Outcome
Gonadotropin-releasing hormone-antagonist
Ovarian stimulation
Progesterone elevation
Stop protocol
Journal
Gynecologic and obstetric investigation
ISSN: 1423-002X
Titre abrégé: Gynecol Obstet Invest
Pays: Switzerland
ID NLM: 7900587
Informations de publication
Date de publication:
2020
2020
Historique:
received:
05
05
2020
accepted:
21
05
2020
pubmed:
25
6
2020
medline:
4
2
2021
entrez:
25
6
2020
Statut:
ppublish
Résumé
The aim of the study was to examine whether the Stop GnRH-agonist combined with multiple-dose GnRH-antagonist protocol may overcome progesterone elevation during the late follicular phase. A cohort historical, proof of concept study consisting of 11 patients with progesterone elevation (>3.1 nmol/L) during conventional IVF/intracytoplasmic sperm injection (ICSI), who underwent a subsequent Stop GnRH-agonist combined with multiple-dose GnRH-antagonist ovarian stimulation (OS) protocol, within 3 months of the previous failed conventional IVF/ICSI cycle. The Stop GnRH-agonist combined with multiple-dose GnRH-antagonist COH protocol revealed significantly lower peak progesterone levels, with significantly higher numbers of follicles >13 mm in diameter on the day of hCG administration, oocytes retrieved, mature oocytes, and top-quality embryos, with an acceptable clinical pregnancy rate (18.2%). The combined Stop GnRH-ag/GnRH-ant OS protocol is a valuable tool in the armamentarium for treating patients with progesterone elevation during the late follicular phase. Further large prospective studies are needed to validate our observation and to characterize the appropriate patients' subgroup, which might benefit from the combined Stop GnRH-ag/GnRH-ant COH protocol.
Identifiants
pubmed: 32580194
pii: 000508875
doi: 10.1159/000508875
doi:
Substances chimiques
Hormone Antagonists
0
Gonadotropin-Releasing Hormone
33515-09-2
Progesterone
4G7DS2Q64Y
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
357-361Informations de copyright
© 2020 S. Karger AG, Basel.