Normal pregnancy outcome after inadvertent exposure to long-acting gonadotrophin-releasing hormone agonist in early pregnancy

Five infertile women exposed to long-acting gonadotrophin-releasing hormone agonist (GnRHa) during early pregnancy were studied to assess the risks of embryotoxicity on the outcome of their pregnancies. All the patients were diagnosed as stage 3-4 endometriosis following laparoscopy, Long-acting GnR Ha (3.75 mg) was given in the first 3 days of their preceding menstrual per iod. Four of the five patients had two GnRHa injections and the last patien t had three GnRHa injections. All patients were advised to use a barrier co ntraception (condoms) throughout the treatment period. Since all complained of no bleeding following the initial injections, human chorionic gonadotro phin (beta-HCG) concentrations were tested in order to rule out any pregnan cy. Ultrasonographic examinations were commenced routinely and all patients had amniocentesis at 16-18 weeks gestational age. Genetic analysis reveale d a normal karyotype in all fetuses. All five pregnancies progressed to ter m without complication, and normal healthy infants were delivered. Although there are still no clear answers concerning teratogenic and hormonal effec ts of GnRHa exposure in pregnancy, our data may suggest that luteal functio n, genetic structure and pregnancy outcome are not adversely affected by Gn RHa, Since possible subtle effects on fetal endocrine organs cannot be disr egarded, close monitoring is still needed in GnRHa-exposed pregnancies.