LEUPROLIDE ACETATE FOR INDUCING OVULATION IN WOMEN UNDERGOING OVARIANSTIMULATION

OBJECTIVE: To determine whether leuprolide acetate (LA), given subcuta neously at the time of follicular maturity in stimulated cycles, can r esult in ovulation and in vivo fertilization. STUDY DESIGN: Sixty-seve n women underwent 91 cycles of ovarian stimulation (OS) and received a single subcutaneous injection of 1 mg of LA when follicular maturity was reached. Only clomiphene citrate (CC) was used for 15 cycles, CC/F SH for 66 cycles and human menopausal gonadotropin only for 10 cycles. Thirty-four cycle were in oligoovulatory women. Eighty-two cycles wer e combined with intra-uterine insemination. RESULTS: Viable pregnancie s occurred in 21/92 cycles (23%). Fourty-two women testing with home u rinary luteinizing hormone (LH) kits noted a surge. Seventy-one or 71 cycles demonstrated a biphasic curve. Sixty-eight of 75 cycles demonst rated follicular collapse (91%). Six women had serum LH levels of 12 /- 4, 136 +/- 22 and 17 +/- 3 mIU/mL before and 12 and 36 hours after LA, respectively. CONCLUSION: LA successfully induced ovulation, ferti lization and luteinization in women receiving OS. The pituitary LH res ponse to LA appeared to be normal in women having OS. The pregnancy ra te was similar to that generally observed with human chorionic gonadot ropin (hCG). A large, prospective, randomized study may be warranted t o compare LA to hCG since the subcutaneous route of LA administration and potential for reduced hyperstimulation could be significant advant ages, making OS more practical and safe.