PREGNANCY OUTCOME FOLLOWING EXPOSURE TO GONADOTROPIN-RELEASING-HORMONE ANALOG DURING EARLY-PREGNANCY - COMPARISONS IN PATIENTS WITH NORMAL OR ELEVATED LUTEINIZING-HORMONE

The outcomes of established pregnancies following the treatment of inf ertile women with pituitary down-regulation before and during treatmen t with ovulation induction and either intrauterine insemination or tim ed intercourse were reviewed, Once started on gonadotrophin-releasing hormone analogue (GnRHa) treatment, the patients were maintained on Gn RHa therapy throughout the following luteal phase to facilitate the st art of the next treatment cycle if no pregnancy was established, This resulted in patients taking GnRHa until a positive pregnancy test indi cated cessation of the treatment, The aim of our study was to determin e whether exposure to GnRHa during early pregnancy constituted a risk, Patients who were diagnosed as having elevated follicular phase lutei nizing hormone (LH) concentrations during their investigations were an alysed as a separate cohort to assess whether this diagnosis had impli cations with respect to pregnancy outcome, Out of 226 recorded clinica l pregnancies, 173 were traced and the data collated: 16 cases resulte d in clinical abortions, two were ectopic pregnancies and 155 women ha d live births at various ages of gestation, There were three pregnanci es which were complicated by congenital abnormalities, Patients with e levated LH concentrations on examination showed a higher rate of total pregnancy loss than those with normal LH concentrations, despite the fact that the LH was suppressed during the cycle in which they conceiv ed, The results suggest that pregnancy outcome is not adversely affect ed by GnRHa administration during the luteal phase of the conception c ycle, and that the group diagnosed as having elevated LH concentration s may retain their propensity to higher rates of pregnancy loss even w hen their LE-I concentrations are suppressed during treatment.