BASE-LINE CYST FORMATION AFTER LUTEAL-PHASE GONADOTROPIN-RELEASING-HORMONE AGONIST ADMINISTRATION IS LINKED TO POOR IN-VITRO FERTILIZATION OUTCOME

Objective: To investigate the prognostic significance of baseline ovar ian cysts after luteal phase GnRH agonist (GnRH-a) administration for IVF-ET. Design: All nondonor IVF-ET cycles in one program in which lut eal phase GnRH-a was administered between July 1993 and January 1994 w ere assessed for the formation of baseline ovarian cysts defined as a mean diameter greater than or equal to 15 mm. Outcome data from the IV F cycles were compared between patients with and without baseline ovar ian cysts. Results: Of 78 IVF cycles, baseline cysts greater than or e qual to 15 mm were noted in 26 cycles. Cycles in which cysts were form ed were associated with significantly older patients with significantl y higher baseline FSH values. Cycles in which cysts were present demon strated fewer follicles, retrieved oocytes, and embryos. Cyst cycles a lso demonstrated a lower peak E(2) level, implantation rate, and clini cal pregnancy rate (PR) per initiated cycle (7.7% versus 32.7%). Cyst cycles also demonstrated a higher cancellation rate. Logistic regressi on modeling, accounting for age, confirmed significantly lower clinica l PRs in cycles with a baseline cyst. Conclusions: Baseline cyst forma tion after luteal phase GnRH-a administration is both a marker for poo r responders and a reliable predictor of poor stimulation and low PRs in a given IVF-ET cycle.