Induction of Ovulation With the Combination of LHRH Analog in a Short Protocol and Exogenous Gonadotropins

  • P. Barriere
  • P. Lopes
  • B. Charbonnel


A better control of ovarian hyperstimulation is an important element in improving results of in vitro fertilization (IVF). Many existing therapeutic protocols utilise substances like clomiphene citrate (CC), human gonadotropins (HMG) or GnRH. Because of the overall satisfactory results, the gonadotropins alone or associated with clomiphene citrate have generally been used in the induction of ovulation. However, there are two major drawbacks in these regimens. A proportion of patients show a poor reproductive response due to poor follicular development. The presence of frequent spontaneous LH surges and even elevated LH levels during the late follicular phase before the induction of ovulation by HCG influences the results. To avoid these endogenous pituitary interferences, the production of reversible medical hypophysectomy, by use of GnRH analogs, has been advocated.


Pregnancy Rate Estradiol Level Clomiphene Citrate Ovarian Response Large Follicle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Porter, RN, Smith, W, Caret, IL, Abdul Wahid, NA and Jacobs, HS (1984). Induction of ovulation for in vitro fertilisation using Buserelin and gonadotropins. Lancet, ii, 1284CrossRefGoogle Scholar
  2. 2.
    Fleming, R, Haxton, MJ, Yates, RWS, Conaghan, C and Coutts, JRT (1985). A simple procedure for the induction of multiple follicular growth with blockage of the LH surge in normal women. Program of 67th Annual Meeting of the Endocrine Society, Baltimore, Maryland, USA, Abstract, 149Google Scholar
  3. 3.
    Barriere, P, Lopes, P, Boiffard, JP, Pousset, C, Quentin, M, Sagot, P, L’Hermite, A, Lerat, MF and Charbonnel, B (1987). Use of GNRH analogues in ovulation induction for IVF: benefit of a short administration regimen. J IVF-ET, 4, 64Google Scholar
  4. 4.
    Eibschitz, I, Belaisch-Allart, J and Frydman, R (1986). In vitro fertilization management and results in stimulated cycles with spontaneous LH discharge. Fertil Steril, 45, 231PubMedGoogle Scholar
  5. 5.
    Nader, S, Berkowitz, AS, Maklad, N, Wolf, DP and Held, B (1986). Characteristics of patients with and without gonadotropin surges during follicular recruitement in an in vitro fertilization embryo transfer program. Fertil Steril, 45, 75PubMedGoogle Scholar
  6. 6.
    Lejeune, B, Degueldre, M, Camus, M, Vekemans, M, Opsomer, L and Leroy, F (1986). In vitro fertilisation and embryo transfer as related to endogenous LH rise or HCG administration. Fertil Steril, 45, 377PubMedGoogle Scholar
  7. 7.
    Wolf, P, Ochs, D, Nader, S and Berkowitz, A (1986). Undetected ovulation in in vitro fertilization — embryo transfer patients. Fertil Steril, 5, 892Google Scholar
  8. 8.
    Howies, CM, Mc Namee, MC, Edwards, R G, Goswamy, R and Steptoe, P C (1986). Effect of high tonic levels of luteinizing hormone on outcome in vitro fertilization. Lancet, ii, 521Google Scholar
  9. 9.
    Ben Rafael, Z, Meloni, F, Strauss, JF, Blasco, L, Mastroianni, L and Flickinger, GL (1987). Relationships between polypronuclear fertilization and follicular fluid hormones in gonadotropin treated women. Fertil Steril, 47, 284PubMedGoogle Scholar
  10. 10.
    Meldrum, DR, Tsad, Z, Monroe, SE, Braunstein, GO, Sladek, J, Vale, W, Lu, JKH, Rivier, J, Judd, HL and Chang, RJ (1984), Stimulation of LH fragments with reduced bioactivity following GNRH agonist administration in women. J Clin Endocrin Metab, 58, 755CrossRefGoogle Scholar
  11. 11.
    Abuzeid, MI and Yeoman, R (1987). Luteinizing hormone bioactivity in human menopausal gonadotropin, human chorionic gonadotropin — induced cycles. Fertil Steril, 47, 238PubMedGoogle Scholar
  12. 12.
    Neveu, S, Hedon, B, Bringer, J, Chincholle, JM, Arnal, F, Humeau, C, Cristol, P and Viala, JL (1987). Ovarian stimulation by a combination of a GNRH agonist and gonadotropins in IVF. Fertil Steril, 47, 639PubMedGoogle Scholar
  13. 13.
    Eppig, JJ (1986). Action de la LHRH sur l’ovaire. Contracept Fertil Sexualte, 14, 859Google Scholar
  14. 14.
    Bramley, TA, Menzies, GS and Baird, DT (1985). Specific binding of gonadotrophin-releasing hormone and an agonist to human corpus luteum homogenates: characterization, properties and luteal phase levels. J Clin Endocrinol Metab, 61, 834PubMedCrossRefGoogle Scholar
  15. 15.
    Chong, AP, Rafael, RW and Forte, CC (1986). Influence of weight in the induction of ovulation with HMG and HCG. Fertil Steril, 46, 599PubMedGoogle Scholar
  16. 16.
    Salat-Baroux, J, Cornet, D, Antoine, JM, Alvarez, S, Alfiere, L and Bonnardot, JP (1987). Un cas de stimulation grave au cours d’une fecondation in vitro suivie de grossesse. Gynecologie, 38, 113Google Scholar
  17. 17.
    Porter, R, Smith, W, Craft, I, Abdul Wahid, N and Jacobs, H (1986). Induction of multifol1icular development for IVF using buserelin and gonadotropins: clinical and endocrine results. J IVF-ET, 3, 174Google Scholar
  18. 18.
    Zorn, JR(1987). Les analogues de la LHRH et les nouvelles techniques d’induction de l’ovulation pour la fecondation in vitro et le transfert intratubaire des gametes. Contracept Fertil Sexualte, 15, 771Google Scholar
  19. 19.
    Chillick, CF, Itskovitz, J, Hahn, DW, McGuire, JL, Danforth, DR and Hodgen GD (1987). Characterizing pituitary response to the gonadotropin releasing hormone antagonist in monkeys: tonic follicle stimulating hormone/luteinizing hormone secretion versus acute GnRH challenge tests before, during and after treatment. Fertil Steril, 48, 480Google Scholar
  20. 20.
    Lyles, R, Gibbons, WE, Dodson, MG, Poindexter, AN, Young, RL, Rossavik, IK and Findley, WE (1985). Characterization and response of women undergoing repeat cycles of ovulation induction in an in vitro fertilization and embryo transfer program. Fertil Steril, 44, 832PubMedGoogle Scholar
  21. 21.
    Belaish-Allart, J, Frydman, R, Fries, N and Testart, J (1986). FSH purifiee et fecondation in vitro. Contracept Fertil Sexualte, 14, 697Google Scholar
  22. 22.
    Kenigsberg, D, Littman, BA, Williams, R and Hodgen, GD (1984). Medical hypophysectomy — Variability of ovarian response to gonadotrophin therapy. Fertil Steril, 42, 116PubMedGoogle Scholar
  23. 23.
    Neveu, S, Hodon, B, Mares, P, Bringer, J, Arnal, F, Deschamps, F, Cristol, P and Humeau, P (1987). Experience en FIV d’un agoniste du GNRH: la Buserelin. Contr Fertil Sexualte, 14, 774Google Scholar
  24. 24.
    Messinis, TE and Templeton, A (1986). Urinary oestrogen levels and follicle ultrasound measurement in Clomifene induced cycles with an endogenous LH surge. Brit J Obstet Gynecol, 93, 43CrossRefGoogle Scholar
  25. 25.
    Friedrich, W, Lire, K, Korner, H and Wilken, T (1986). The follicular phase stimulated by human pituitary gonadotrophin and the luteal phase following IVF. Exptl Clin Endocrinol, 87,1CrossRefGoogle Scholar
  26. 26.
    Levran, D, Lopata, A, Nayerden, PL, Martin, MJ, McBain, JC, Baylay, CM, Speirs, AL and Johnston, WIH (1985). Analysis of the outcome of IVF in relation to the timing of HCG administration by the duration of estradiol rise in stimulated cycles. Fertil Steril, 44, 335PubMedGoogle Scholar
  27. 27.
    Quigley, MM, Sokoloski, JE and Richards, SI (1985). Timing HCG administration by days of oestradiol rise. Fertil Steril, 44, 791PubMedGoogle Scholar
  28. 28.
    Zarutskie, PW, Kuzan FB, Dixon, L, Soules, MR (1987). Endocrine changes in the late follicular and postovulatory intervals as determinants of the IVF pregnancy rate. Fertil Steril, 47, 137PubMedGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • P. Barriere
    • 1
  • P. Lopes
    • 1
  • B. Charbonnel
    • 1
  1. 1.IVF DepartmentCHU NantesNantes Cedex 01France

Personalised recommendations