THE EFFECTS OF GONADOTROPIN-RELEASING-HORMONE AGONIST ON ANDROSTENEDIONE PRODUCTION AND FOLLICULAR DEVELOPMENT DURING CONTROLLED OVARIAN HYPERSTIMULATION

Purpose: We performed a prospective randomized study to assess the eff ects of a GnRH agonist (GnRH-a) on follicular development and steroido genesis during controlled ovarian hyperstimulation (COH). Methods: Pat ients undergoing in vitro fertilization (IVF)for tubal infertility rec eived human menopausal gonadotropin (hMG) stimulation with or without the GnRH-a, buserelin, beginning in the midluteal phase of the prior c ycle. We analyzed serum hormone levels, follicular development, and ou tcome of IVF. Results: The mean number of retrieved oocytes was signif icantly greater and the implantation rate per embryo was significantly higher in the GnRH-a/hMG group (n = 101) than in the hMG-only group ( n = 97). The concentration of androstenedione (A) and the Alestradiol ratio in the serum were significantly lower in the GnRH-a treatment gr oup throughout the follicular phase. Conclusions: The concomitant use of GnRH-a during COH prevents atretic change of the follicles and enha nces follicular development by reducing androgen accumulation, resulti ng in a higher developmental competence of the oocytes.