SUPPRESSION OF THE ENDOGENOUS LH INCREASE IN OVARIAN STIMULATION BY GNRH ANTAGONIST CETRORELIX

Surges of LH in serum, which result in luteinisation, but occur premat urely with respect to the diameter of the leading follicle, frustrate attempts to induce multiple follicular maturation for in-vitro fertili sation in a number of women. We examined the possibility of blocking p remature LH-surges by the administration of Cetrorelix, a potent antag onist of gonadotrophin releasing hormone. Twenty patients, who had rep eatedly shown premature LH surges, were treated with human menopausal gonadotrophins from the 2nd day onwards. From the 7th day until the in duction of ovulation by HCG, the GNRH-antagonist Cetrorelix was given daily. HCG was injected when the dominant follicle had reached the dia meter of at least 18 mm and oestradiol levels were above 300 pg for ea ch follicle and more than 15 mm. Oocyte collection was performed 36 ho urs later by transvaginal ultrasound puncture, followed by IVF and emb ryotransfer. The hormone profiles of these patients and the results of in-vitro fertilisation and embryotransfer are discussed. It could be demonstrated in this study, that combined treatment with gonadotrophin s and the GNRH-antagonist seems to be a promising method for ovarian s timulation in patients, who frequently exhibit premature LH discharges and therefore fail to complete treatment.