Continuous use of gonadotropin-releasing hormone (GnRH)-agonist maintains high luteinizing hormone concentrations at the time of oocyte retrieval in women undergoing GnRH-agonist long protocol assisted reproductive technology treatment and stimulation with recombinant follicle-stimulating hormone

Introduction: The objective of this study was to evaluate the changes in serum luteinizing hormone (LH) concentrations in infertile women undergoing continuous gonadotropin-releasing hormone (GnRH)-agonist long protocol and rec-follicle-stimulating hormone (rec-FSH) assisted reproductive technology (ART) treatment from the time of human chorionic gonadotrophin (hCG) administration until oocyte retrieval.
Material and methods: Between October 2006 and October 2007, 100 GnRH- agonist long protocol and rec-FSH ART treatment cycles from 86 patients who underwent ART were divided into two groups according to the duration of GnRH-agonist administration. Assisted reproductive technology treatment cycles during which administration of GnRH-agonist was stopped 36-40 h before oocyte retrieval comprised the standard GnRH-a group (n = 37). The remaining cycles during which GnRH-agonist was administered until oocyte retrieval constituted the continuous GnRH-a group (n = 63). Hormonal profiles and ART outcomes were compared between treatments in a retrospective study.
Results: On the day of hCG administration, LH concentrations in the standard (1.1 ±0.1 IU/l) and continuous (1.3 ±0.4 IU/l) GnRH-a groups were similar. However, on oocyte retrieval, LH concentration of the standard group was dramatically reduced (0.1 ±0.003 IU/l), while that of the continuous GnRH-a group remained unchanged and was significantly greater than the standard group (0.6 ±0.1 IU/l, p < 0.0001). The standard and continuous GnRH-a treatment groups exhibited comparable pregnancy rates (18.8% in the standard group and 24.1% in the continuous group).
Conclusions: Continuous administration of GnRH-agonist until oocyte retrieval maintains high LH concentrations and does not negatively affect ART outcome.