Serum and follicular fluid hormone levels during in vitro fertilization after short- or long-course treatment with a gonadotropin-releasing hormone agonist

Objective: To examine the impact of flare (short) vs. down-regulation (long ) GnRH agonist (GnRH-a) on serum and follicular fluid (FF) LH and androgen concentrations in women undergoing IVF treatment cycles. Design: Prospective observational study. Setting: IVF clinic. Patient(s): One hundred sixteen ovulatory subjects undergoing IVF. Interven tion(s): Fifty-eight ovulatory patients undergoing a down-regulation regime n matched with 58 undergoing the flare regimen as part of an IVF cycle. Main Outcome Measure(s): Serum concentrations of LH, FSH, Progesterone (P4) , Androstenedione (A), T, and a on the day of hCG administration were compa red between the two groups. In addition, the FF P4, 170HP4. A, T. and E-2 l evels were compared in the two groups. Result(s): Serum LH was significantly higher with the flare regimen (15.2 /- 1.14 IU/L, P<.05) when compared with results with the down-regulation pr otocol (9.5 <plus/minus>: 0.77 IU/L). In addition, FF A was significantly h igher in the flare protocol (57.3 +/- 13.3 ng/mL, P<.05) compared with in t he dawn-regulation protocol (27 <plus/minus> 2.44 ng/mL). Serum and FF P4, 170H P4, T, and E, were not statistically significantly different between t he two groups. Conclusion(s): Serum LH and FF A are significantly higher in the flare regi men in comparison with the down-regulation regimen. Circulating LH appears to play a role in determining FF a concentration. (C) 2001 by American Soci ety for Reproductive Medicine.