O. Gregoriou et al., Evaluation of ovarian cysts following GnRH-a treatment in patients with polycystic ovarian syndrome, GYNECOL OBS, 46(4), 1998, pp. 252-255
The aim of this study was to evaluate the ovarian cysts appearing during Gn
RH-a/hMG treatment in patients with polycystic ovarian syndrome (PCOS). A t
otal of 35 women with PCOS were included in the study. All women received 3
.75 mg IM of long-acting leuprolide acetate on the first day of the menstru
al cycle. On the 15th day of the menstrual cycle, transvaginal ultrasound e
xamination (US) and determination of serum E-2 were done. A total of 90 cyc
les were studied in this way and during these cycles, 14 (15.5%) ovarian cy
sts with a diameter of greater than or equal to 20 mm developed. According
to the serum E-2 levels, 11 cases (group A) had E-2 concentrations > 35 pg/
ml and 3 (group B) had serum E-2 levels < 35 pg/ml. Group A patients attain
ed a significantly larger mean size of ovarian cyst than group B patients(4
2 +/- 7.3 vs. 24.2 +/- 3.2 mm, p < 0.001). When the serum E-2 concentration
s were < 35 pg/ml, the ovarian cysts were disregarded and ovarian stimulati
on with gonadotropins was initiated. In case that serum E-2 levels were > 3
5 pg/ml, the initiation of the ovarian stimulation with hMG was postponed u
ntil serum E-2 levels indicated down-regulation, which was achieved after 5
.8 +/- 2.9 days. In both groups the ovarian stimulation resulted in ovulato
ry cycles, while four pregnancies in group A and one in group B were achiev
ed. In conclusion, our results indicate that in patients with PCOS the GnRH
-a administration may cause follicular cysts at an incidence of 15.5%. Thes
e cysts do not constitute a contraindication for ovarian stimulation provid
ed that serum E-2 levels are low.