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Clinical Assisted Reproduction

IR@IICB: CSIR-Indian Institute of Chemical Biology, Kolkata

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Title Clinical Assisted Reproduction
Creator Goswami, S K
Chakraborty, B N
Kabir, S N
Subject Chemistry
Description Purpose: Our purpose was to evaluate the IVF-ET outcome in patients who did not achieve timely pituitao,-ovarian suppression following "long"-protocol GnRH agonist ( GnRH-a ) administration. Methods: A retrospective analysis was done on 96 IVF treatment cycles characterized by a delayed response (DR) to long-protocol GnRH-a treatment. The study included those patients who either achieved ovarian suppression (E2 <-- 110 pM) despite an elevated LH level (group DR-A) or had pituita~' desensitization (LH <- 1.5 IUIL) without ovarian suppression (group DR-B) on day 12 of GnRH-a treatment but needed an extended course of GnRH-a treatment to achieve complete suppression. These patients had gonado- tropin stimulation either from day 12, despite an elevated level of LH (subgroup DR-A 1; n = 13) or elevated E~ levels (subgroup DR-BI; n = 9), or after achieving a complete hypogonadotropic-hypopgonadal state following an extended course of GnRH-a treatment [subgroups DR-A2 (n = 46) and DR-B2 (n = 28)1. The outcome was compared with that of 88 cycles of normal responders (group NR) who had pituitary-ovarian suppression by day 12 o f GnRH- a administration. Results: Ovarian response and pregnancy rates in subgroups DR-A 1 and DR-A2 were statistically not different and com- parable to those in the NR group. In subgroups DR-B1 and DR-B2, E. 2 response and rates of oocyte retrieval and pregnancy were signoqcantty lower than those in the other groups, but fertilization and cleavage rates were similar. The requirement of gonadotropin for ovarian stimulation was comparatively higher in subgroup DR-A2 and both DR- B subgroups. Conclusions: There was no treatment cancellation in group NR attd both DR-A subgroups, but 22% t~f the cw'les in DR- BI and 14% of the cycles in DR-B2 were canceled due to poor ovarian response. It therefore appears that during long- protocol pituita~, desensitization, the post-GnRH-a level ~ serum E,_, rather than LH, better predicts IVF-ET outcome.
Date 1996
Type Article
Format application/pdf
Identifier http://www.eprints.iicb.res.in/712/1/JOURNAL_OF_ASSISTED_REPRODUCTION_AND_GENETICS%2C_13(_5)%2C_374%2D380_[42].pdf
Goswami, S K and Chakraborty, B N and Kabir, S N (1996) Clinical Assisted Reproduction. Journal of Assisted Reproduction and Genetics, 13 (5). pp. 374-380.
Relation http://dx.doi.org/10.1007/BF02066167