THE EFFICACY OF SHORT-TERM GONADOTROPIN-RELEASING-HORMONE AGONISTS VERSUS HUMAN CHORIONIC-GONADOTROPIN TO ENABLE OOCYTE RELEASE IN GONADOTROPIN STIMULATED CYCLES
Jh. Check et al., THE EFFICACY OF SHORT-TERM GONADOTROPIN-RELEASING-HORMONE AGONISTS VERSUS HUMAN CHORIONIC-GONADOTROPIN TO ENABLE OOCYTE RELEASE IN GONADOTROPIN STIMULATED CYCLES, Human reproduction, 8(4), 1993, pp. 568-571
One of the reasons for failure to conceive following human menopausal
gonadotrophin (HMG) therapy may be due to non-release of oocytes from
the follicles. We hypothesized that by using a gonadotrophin-releasing
hormone agonist (GnRHa) for a short duration, endogenous release of l
uteinizing hormone and follicle stimulating hormone may enable oocyte
release to occur, similar or superior to the effect of human chorionic
gonadotrophin (HCG). This study attempted to compare the efficacy of
HCG versus the GnRHa leuprolide acetate to release oocytes and achieve
pregnancies and to compare the effectiveness of leuprolide acetate ve
rsus a combination of HCG with HMG to release oocytes. Unfortunately d
ue to lack of prior data, many patients preferred to reject leuprolide
acetate in favour of HCG, resulting in three times as many patients b
eing treated with HCG in cycle 1; 78.2% of oocytes were released follo
wing leuprolide acetate versus only 55.7% with HCG. Interestingly, 87.
5% of those females in whom oocyte release failed in cycle 1 with HCG
did indeed release with leuprolide acetate in cycle 2, but none of the
se previous failures released with HCG in cycle 2. Pregnancy rates wer
e equal in those women releasing oocytes, whether treated with HCG or
leuprolide acetate. These preliminary data justify a larger randomized
study.