A randomized controlled study comparing the endocrine effects of pulsatile intravenous gonadotropin-releasing hormone after gonadotropin-releasing hormone agonist pretreatment versus clomiphene citrate in patients with polycystic ovary syndrome

• Published in: Fertility and sterility Vol. 73; no. 6; pp. 1145 - 1148
• Main Authors: Timmerman-van Kessel, Esther C.M, Cikot, Rolf J.L.M, Dargel-Donkers, Els J.H, Zwertbroek, Werner, van Dop, Peter A, Schoot, Dick C
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2000; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Clomiphene - therapeutic use; clomiphene citrate; Endocrine Glands - drug effects; Estradiol - blood; Female; Fertility Agents, Female - therapeutic use; Follicle Stimulating Hormone - blood; Follicular Phase; Genital system. Reproduction; GnRH agonist; Gonadotropin-Releasing Hormone - agonists; Gonadotropin-Releasing Hormone - therapeutic use; Humans; Infertility, Female - blood; Infertility, Female - drug therapy; Injections, Intravenous; Luteinizing Hormone - blood; Medical sciences; PCOS; Pharmacology. Drug treatments; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - drug therapy; Progesterone - blood; Pulsatile Flow; pulsatile gonadorelin; clomiphene citrate; PCOS; GnRH agonist; pulsatile gonadorelin; Non steroidal estrogen; Agonist; Intravenous administration; Estrogen; Gonadotropin RH; Polycystic ovary; Estradiol; Randomization; Cyst; Luteinizing hormone; Clinical trial; Female; Benign neoplasm; Hormone releasing factor; Follicle stimulating hormone; Human; Female sterility; Gonadotropin; Clomifene; Ovarian hormone; Female genital diseases; Hypothalamic hormone; Ovarian diseases; Adenohypophyseal hormone; Gonadorelin; Sex steroid hormone
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(00)00535-5

Objective: To compare the endocrine changes in the follicular phase in infertile patients with polycystic ovary syndrome (PCOS) treated with either pulsatile IV GnRH after GnRH-agonist (GnRH-a) down-regulation or clomiphene citrate (CC). Design: Subgroup analysis within a randomized, controlled, multicenter study. Setting: Women referred to the Infertility Clinic, Catharina Hospital Eindhoven, The Netherlands. Patient(s): Twenty-eight infertile patients with PCOS. Intervention(s): Patients were randomly assigned to pulsatile IV GnRH (10–20 μg/90 min) after GnRH-a down-regulation or CC (50–150 mg; cycle days 3–7). Patients were monitored on alternate days with ovarian sonography and serum concentrations of E 2, LH, and FSH. Serum P and sonography confirmed ovulation. Main Outcome Measure(s): Serum concentrations of E 2, LH, and FSH were assessed before treatment was started and after each ovarian sonography. Result(s): In ovulatory cycles, no statistically significant differences were observed during the follicular phase comparing serum concentrations of E 2, LH, and FSH between the treatments. However, a significant increase in LH occurred in the GnRH group. Conclusion(s): No significant endocrine differences were observed between GnRH and CC treatment. However, there was a significant increase in the serum LH concentration during the follicular phase in the GnRH group. Increments of LH in the GnRH group may be due to recovery of endogenous LH secretion.