Hormonal features of IVF cycles stimulated with human menopausal gonadotropin and recombinant follicle-stimulating hormone in gonadotropin-releasing hormone antagonist protocols


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Abstract

Objective. To assess the hormonal prof ile in the use of recombinant follicle-stimulating hormone (rFSH) and human menopausal gonadotropin (hMG) in the cycles with a gonadotropin-releasing hormone antagonist (GnRH-ant) and its effect on conception rate. Subject and methods. The standard GnRH-antprotocols were used to induce superovulation with hMG and rFSH in 90 and 100 women, respectively. The investigators measured the levels of luteinizing hormone (LH), FSH, estradiol (E2), progesterone (P) before stimulation and LH, E2, and P on the day of initiation of GhRH-ant injection and on the day of ovulation trigger administration. Furthermore, oo- and embryogenetic parameters and conception rates were estimated in both groups. Results. Premature luteinization (an increase in progesterone levels on the day of administration of a trigger > 4.7 nmol/l) in the hMG cycles occurred in 7.7% of cases and in the rFSH programs in 6% (p > 0.05). In the rFSH group, the preovulatory E2 levels were significantly higher than those in the hMG group (p < 0.05%). On day 6 of stimulation, there were significant differences between P levels in the rFSH-stimulated cycles with and without premature luteinization in the absence of significant differences in LH and E2 levels. In the hMG-stimulated cycles, there were significantly higher P and E2 levels, starting on day 3 of stimulation during premature luteinization. Both groups showed premature luteinization when larger starting and cycle gonadotropin doses and longer stimulation were used. In the rFSH group, the mean number of growing follicles was higher than that in the hMG group - 10.5±4.4 and 8.2±3.5, respectively (p < 0.05). The oo- and embryogenetic parameters were similar in the groups with the luteinization found and normal preovulatory P values in the use of both rFSH and hMG. The conception rate in the rFSH and hMG groups was 37 and 36%, respectively. Conclusion. Thus, this investigation demonstrated differences in the trend of folliculogenesis and steroidogenesis of an induced cycle depending on the ovulation inductor used. Fewer follicles were the specific features of hMG-induced folliculogenesis, which corresponded to the lower serum levels of total E2. Premature luteinization and clinical pregnancy rates and oo- and embryogenetc parameters were similar when rFSH and hMG were used.

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About the authors

L. V Vinogradova

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: Kalugina-LV@mail.ru
graduate student

N. G Mishieva

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@mail.ru
MD, Senior researcher of 1st gynecology department

A. N Abubakirov

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@yahoo.com
PhD, Head of 1st gynecology department

L. A Levkov

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: lev.levkov@gmail.com
MD, PhD, Advisor of director

M. V Martynova

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: Martinova_m@bk.ru
graduate student

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