Presented by HsinYang Li

1

• Presented by Hsin-Yang Li
• OB/GYN Dept., Taipei VGH

2
Premature LH Surge

• Without the use of GnRH agonists or antagonists,
  premature LH surges occurs in ?20 of
  gonadotropin stimulated cycles
• Premature LH surges induces atresia of follicles
  and exerts negative effects on the endometrium

3
Ways to Prevent Premature LH Surge in Controlled
Ovarian Stimulation
(Coccia ME., et. al., 2004)
4
Most Commonly Used Protocols
Long GnRH agonist 1. Slightly better pregnancy
rate 2. More injections needed
(Semin. Reprod. Med., 2002)
5
(No Transcript)
6
(No Transcript)
7
Conclusion

• GnRH antagonist regimens
• 1) Endogenous FSH ? during the early follicular
  phase ? less synchronization of the follicular
  cohort ? less mature oocytes
• 2) Endogenous LH ? during the early follicular
  phase ? slight progesterone ? ? endometrial
  receptivity for the embryos ?
• Ways to improve GnRH antagonist regimens
• 1) GnRH antagonist starts from FSH D1
• 2) OCP pretreatment x 18-28 d? 2 d? FSH ? GnRH
  antagonist from FSH D5-6