Combined clomiphene citrate (CC) and human menopausal gonadotropins (hMG) in a fixed schedule for follicular recruitment during in vitro fertilization: Effects on premature luteinizing hormone (LH) surges
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Recognizing the association between plasma progesterone (P) and an imminent LH surge, we investigated the frequency of P elevation in our stimulation protocol (clomiphene citrate-human menopausal gonadotropins). P was measured retrospectively on the day before, the day of, and the day after human chorionic gonadotropin hCG administration. The means ±2 standard deviations for P were as follows: day before hCG, 0.58±0.86; day of hCG, 0.64 ± 0.56; and day after hCG, 1.47 ± 1.22. Seven patients (8%) had P levels greater than 2 SD above the mean.
Significant P elevations prior to hCG are infrequent with this protocol, and in the few patients with raised P a trend toward lowered fertilization was noted. The low incidence of P elevation may be secondary to the administration of hCG in a timely manner on the sixth day of estradiol (E2) rise.
KeywordsStandard Deviation Citrate Progesterone Estradiol Developmental Biology
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- 1.Lejeune B, Degueldre M, Camus M, Vekemans M, Opsomer L, Leroy F: In vitro fertilization and embryo transfer as related to endogenous luteinizing hormone rise or human chorionic gonadotropin administration. Fertil Steril 1986;45:377–383Google Scholar
- 2.Huang K, Chang SY, Muechler EK, Graham MC: The outcome of continued treatment of luteinizing hormonesurged cycles in in vitro fertilization with the use of human menopausal gonadotropin. Fertil Steril 1987;47:816–820Google Scholar
- 3.Quigley MM, Sokoloski JE, Richards SI: Timing human chorionic gonadotropin administration by days of estradiol rise. Fertil Steril 1985;44:791–795Google Scholar
- 4.Seifer DB, Collins RL, Paushter DM, George CR, Quigley MM: Follicular aspiration: A comparison of an ultrasonic endovaginal transducer with fixed needle guide and other retrieval methods. Fertil Steril 1988;49:462–467Google Scholar
- 5.Howles CM, Macnamee MC, Edwards RG, Goswamy R, Steptoe PC: Effect of high tonic levels of luteinizing hormone on outcome of in vitro fertilization. Lancet 1986;2:521–522Google Scholar
- 6.Hodgen GD: Physiology of follicular maturation.In In Vitro Fertilization—Norfolk. Baltimore, MD, Williams & Wilkins, 1986, pp 8–29Google Scholar
- 7.Kerin JF, Quinn PJ, Seamark RF, Warnes GM, Jeffrey R, Matthews CD, Cox LW: Incidence of multiple pregnancy after in-vitro fertilisation and embryo transfer. Lancet 1983;2:537–540Google Scholar
- 8.Bomsel-Helmreich O, Huyen LVN, Durand-Gasselin I, Salat-Baroux J, Antoine JM: Mature and immature oocytes in large and medium follicles after clomiphene citrate and human menopausal gonadotropin stimulation without human chorionic gonadotropin. Fertil Steril 1987;48:596–604Google Scholar
- 9.Hoff JD, Quigley ME, Yen SSC: Hormonal dynamics at midcycle: A reevaluation. J Clin Endocrinol Metab 1983;57:792–796Google Scholar
- 10.Serafini P, Stone B, Kerin J, Batzofin J, Quinn P, Marrs RP: Occurrence of a spontaneous luteinizing hormone surge in superovulated cycles-predictive value of serum progesterone. Fertil Steril 1988;49:86–89Google Scholar
- 11.Messinis JE, Templeton A, Baird DT: Endogenous luteinizing hormone surge during superovulation induction with sequential use of clomiphene citrate and pulsatile human menopausal gonadotropin. J Clin Endocrinol Metab 1985;61:1076–1080Google Scholar
- 12.Glasier A, Thatcher SS, Wickings EJ, Hillier SG, Baird DT: Superovulation with exogenous gonadotropins does not inhibit the luteinizing hormone surge. Fertil Steril 1988;49:81–85Google Scholar