DO THE SUPPRESSION CRITERIA IN GNRH-A CYCLES PREDICT IN-VITRO FERTILIZATION OUTCOME

The addition of gonadotropin releasing hormone analog (GnRH-a) to cont rolled ovarian hyperstimulation regimes has been reported to have seve ral advantages, such as reduced cancellation vote, fewer premature lut einizations and increased clinical pregnancy rare. The aim of this stu dy was to determine the effect of pituitary/ovarian suppression, in te rms of the levels of luteinizing hormone (LH), estradiol and follicle stimulating hormone (FSH), and the duration of GnRH-a administration, on in vitro fertilization (IVF) outcome. Retrospectively, 153 IVF cycl es with GnRH-a and human menopausal gonadotropin (hMG) were examined. After a minimum of 10 days of GnRH-a administration, the patients were started on hMG. The correlations were investigated between the fertil ization rates, the numbers of retrieved oocytes and transferred embryo s, the cancellation rates, the suppressed LH, FSH and estradiol levels , the total ampules of hMG used and the duration of GnRH-a usage. The duration of GnRH-a usage and the total ampules of hMG used were not co rrelated. The number of oocytes retrieved and total number of hMG ampu les used showed weak correlations with suppressed levels of FSH (-0.29 7 and 0.285, respectively). However, the fertilization, cleavage and p regnancy rates did not correlate with the LH, FSH and estradiol levels on hMG start days. In conclusion, for selected cases, 10 days of GnRH -a administration is sufficient to suppress endogenous gonadotropin le vels. Since FSH and LH are protein hormones and their bioactivity may change in a manner that is unrelated to their immunological levels, it is not necessary to measure FSH, LH and estradiol levels to detect wh ether suppression is adequate.