THE EFFECTS OF GONADOTROPIN-RELEASING-HORMONE AGONIST ON FOLLICULAR DEVELOPMENT IN PATIENTS WITH POLYCYSTIC-OVARY-SYNDROME IN AN IN-VITRO FERTILIZATION AND EMBRYO-TRANSFER PROGRAM

The aim of the study was to evaluate ovarian response to gonadotrophin stimulation, with and without premedication with gonadotrophin-releas ing hormone (GnRH) agonist, in patients with polycystic ovary syndrome . In all, 40 women included in the in-vitro fertilization/embryo trans fer programme were divided into two groups. Tn the first group, busere lin, 500 mu g/day s.c., was given until pituitary desensitization was achieved. Ovarian stimulation was performed by the combination of GnRH agonist and human menopausal gonadotrophin (HMG)). The second group w as treated using a conventional HMG and human chorionic gonadotrophin (HCG) protocol. Desensitization was achieved in 15.2 +/- 6.3 days (mea n +/- SD) and the luteinizing hormone:follicle stimulating hormone rat io decreased from 2.84 +/- 1.54 to 0.60 +/- 0.35. Comparing the durati on of stimulation, the number and size of all observed and aspirated f ollicles, oocytes recovered and fertilized and the number of embryos r eplaced, no statistically significant differences were found between t he groups. The average oestradiol concentration on the day of HCG admi nistration was lower in the group treated with premedication (P < 0.05 ). These data suggest that short pre-treatment with GnRH agonist can t emporarily correct endocrine abnormalities of polycystic ovary syndrom e but do not change the ovarian response to gonadotrophin stimulation and multiple follicular development.