Midcycle administration of single-dose GnRHa for luteal phase failure in women with ovarian hyperstimulation. A report of five cases
Wu, T.C.
Journal of Reproductive Medicine 45(2): 156-158
2000
ISSN/ISBN: 0024-7758 PMID: 10710751 Document Number: 525178
BACKGROUND: Exogenous administration of gonadotropin-releasing hormone agonist (GnRHa) induces an endogenous midcycle gonadotropin surge. However, its use to induce ovulation and maintain luteal function in non-in vitro fertilization patients who receive ovarian stimulation is unknown. CASES: Five infertile women who underwent controlled ovarian hyperstimulation with human menotropin developed multiple ovarian follicles. In an attempt to circumvent the potential ovarian hyperstimulation syndrome, 1 mg of leuprolide acetate was administered subcutaneously to three patients in an attempt to induce the endogenous luteinizing hormone surge. All three patients began menstruation six to seven days after GnRHa administration with serum progesterone levels between 0.2 and 0.5 ng/mL. Similar ovarian stimulation cycles with ovulation induced by human chorionic gonadotropin in these individuals revealed a normal luteal phase length and midluteal progesterone levels. When double doses of leuprolide acetate were used on two patients, normal luteal length and midluteal serum progesterone levels occurred. CONCLUSION: A single bolus of GnRHa during the late follicular phase may be inadequate to initiate normal luteal function in cycles with ovarian hyperstimulation.