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Prolonged GnRH suppression period in controlled ovarian hyperstimulation cycles: Impacts on IVF outcomes?
Ozlem Gun Eryilmaz,Esma Sarikaya,Leyla Mollamahmutoglu,Nedim Cicek
Iranian Journal of Reproductive Medicine , 2012,
Abstract: Background: Prolonged GnRH-a administration in IVF cycles may have some advantages related to the treatment outcomes.Objective: In this study, we aimed to analyse the effect of prolonged gonadotropin releasing hormone agonist (GnRH-a) administration on controlled ovarian hyperstimulation outcomes of in vitro fertilization (IVF) patients.Materials and Methods: In this retrospective study, 55 patients with a GnRH-a administration period more than 10 days were compared with 55 patients whose same period was ≤10 days with respect to the demographic characteristics, metaphase II (MII) oocyte ratio, grade I (GI) embryo ratio, blastocyst ratio, fertilization, implantation, and the clinical pregnancy rates.Results: The mean hospital visit count of the prolonged GnRH-a patients was 2.6±0.4. As we expected, total GnRH-a doses used during hypophyseal down regulation were significantly different between the groups (p<0.0001). MII oocyte, G1 embryo and the blastocyst ratios were also significantly different between the groups (p<0.0001; p<0.01 and p<0.05). All the other parameters were insignificant. Conclusion: Prolonged GnRH-a administration during ovarian suppression in IVF patients may have positive impacts on the oocytes and the embryos, but this affect may not be observed in the overall pregnancy rates.
Aggressive angiomyxoma of the vulva: dramatic response to gonadotropin-releasing hormone agonist therapy  [cached]
Azar Danesh,Mohammad Hossein Sanei
Journal of Research in Medical Sciences , 2007,
Abstract: Aggressive angiomyxoma is a rare soft tissue neoplasm that usually arises within the perineum. It often occurs as a vulvar mass and clinically simulates a Bartholin's gland cyst. Most patients are in the second or third decade of life, but some cases have also been reported in children. This is the report of a 21 year old woman with 4.5 × 3 × 1.5 cm mass in right labia major. The patient underwent wide local excision surgical treatment. Histological examination showed high vascular myxoid tumor containing spindle cells. Immunohistochemical study of cells showed positive reaction to estrogen and progesterone and negative reaction to S100, SMA and desmin. Treatment with a gonadotropin-releasing hormone agonist was administered to deal with residual tumor and prevent local recurrence for 6 months. KEY WORDS: Aggressive angiomyxoma, vulva, pregnancy, Gonadotropin releasing hormone agonist.
Pattern of prolactin secretion after administration of gonadotropin-releasing hormone agonist at the preovulatory phase of intrauterine insemination cycles
Cavagna, Mario;Mantese, Jo?o Carlos;Freitas, Gilberto da Costa;Dzik, Artur;Soares, Jonathas Borges;Hameiry, Yaron;Izzo, Vicente Mario;Pinotti, José Aristodemo;
Sao Paulo Medical Journal , 2005, DOI: 10.1590/S1516-31802005000600010
Abstract: context and objective: administration of a gonadotropin-releasing hormone (gnrh) agonist at the preovulatory phase is an option for triggering ovulation in assisted reproductive technology cycles. the aim of this work was to investigate the pattern of prolactin secretion after the administration of a single dose of gnrh-agonist at the preovulatory phase. design and setting: descriptive study at a tertiary referral center. participants: fifteen normally ovulating patients undergoing ovarian stimulation for intrauterine insemination were studied. methods: ovarian stimulation was carried out using human menopausal gonadotropin (intramuscular 75 iu daily). when at least one follicle reached 17 mm (observed echographically), 0.5 mg of buserelin acetate was administered. blood samples were taken to determine prolactin concentrations, at the time of agonist injection and 4, 8, 12, 24 and 48 hours later. results: a statistically significant increase in serum levels of prolactin was observed 4, 8 and 12 hours after gnrh-agonist administration, with a peak at 8 hours. conclusion: the administration of a single dose of gnrh-agonist at the preovulatory phase in patients undergoing ovarian stimulation performed with human menopausal gonadotropin causes a significant increase in serum prolactin levels.
Overdistended duplicated bladder and sudden fetal demise after inadverdent exposure to long-acting gonadotropin-releasing hormone agonist in early pregnancy  [cached]
Nupur Gupta,Shikha Sarangi,Deepika Deka,Suneeta Mittal
Journal of the Turkish-German Gynecological Association , 2009,
Abstract: Gonadotropin-releasing hormone agonists are being increasingly used in infertility and gynaecological practice for treatment of fibroids, endometriosis and in vitro fertilization cycles.A 24-year-old nulliparous lady with a fibroid uterus had an inadvertent exposure to two doses of leuprolide acetate and conceived spontaneously while awaiting hysteroscopic myomectomy. The fetus suffered anomalies of urogenital system and sudden intrauterine fetal demise at 31 weeks gestation.Till date, no consensus has been gathered on the management of gonadotropin-releasing hormone agonist exposed pregnancies, risk of teratogenecity and perinatal outcome.
Gonadotropin-releasing hormone agonist use in men without a cancer registry diagnosis of prostate cancer
Yong-fang Kuo, James S Goodwin, Vahakn B Shahinian
BMC Health Services Research , 2008, DOI: 10.1186/1472-6963-8-146
Abstract: We used linked Surveillance, Epidemiology and End-Results (SEER)-Medicare data from 1993 through 2001 to identify GnRH agonist use in men with either a diagnosis of prostate cancer registered in SEER, or with a diagnosis of prostate cancer based only on Medicare claims (from the 5% control sample of Medicare beneficiaries residing in SEER areas without a registered diagnosis of cancer). The proportion of incident GnRH agonist users without a registry diagnosis of prostate cancer was calculated. Factors associated with lack of a registry diagnosis were examined in multivariable analyses.Of incident GnRH agonist users, 8.9% had no diagnosis of prostate cancer registered in SEER. In a multivariable logistic regression model, lack of a registry diagnosis of prostate cancer in GnRH agonist users was significantly more likely with increasing comorbidity, whereas it was less likely in men who had undergone either inpatient admission or procedures such as radical prostatectomy, prostate biopsy, or transurethral resection of the prostate.Reliance solely on tumor registry data may underestimate the rate of GnRH agonist use in men with prostate cancer.Prostate cancer is the most frequently diagnosed non-skin malignancy and is the third leading cause of cancer mortality in men in the United States [1]. Use of androgen deprivation therapy for prostate cancer in the form of gonadotropin-releasing hormone (GnRH) agonists is now common, with nearly half of men receiving it at some point in their disease course [2]. Historically the use of androgen deprivation therapy was limited to palliation of metastatic prostate cancer. However, the 1990s witnessed a dramatic increase in use of GnRH agonists for prostate cancer across all stages and grades [3,4], even though a survival benefit has only been demonstrated in combination with radiation in the subset of patients with locally advanced or high risk disease or following radical prostatectomy in men with node-positive cancer [5-7].Coupl
Validity of the recorded codes of gonadotropin-releasing hormone agonist treatment and orchiectomies in the Danish National Patient Registry  [cached]
Jespersen CG,Borre M,Nørgaard M
Clinical Epidemiology , 2012,
Abstract: Christina Gade Jespersen,1,2 Michael Borre,1 Mette N rgaard21Department of Urology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, DenmarkPurpose: Large-scale observational studies based on existing medical databases may have an important role in studies of long-term effects of different treatments in prostate cancer patients if the coding of the treatment is valid. We therefore estimated the positive predictive value (PPV) and negative predictive value (NPV) of hospital codes for gonadotropin-releasing hormone (GnRH) agonist treatment and orchiectomies in the Danish National Patient Registry (DNPR).Patients and methods: From Danish prostate cancer patients we selected 100 patients who were registered as users of GnRH agonists, 100 patients who were registered as nonusers of GnRH agonists, 50 patients who were registered as bilateral orchidectomized, and 50 patients who were not registered as orchidectomized in the DNPR between January 1, 2002 and December 31, 2008. From the patients' medical files we recorded codes for GnRH agonist treatment and orchiectomies, including dates of treatment from date of first prostate cancer diagnosis and onward.Results: The PPV of GnRH agonist treatment coding in the DNPR was 93% (95% confidence interval [CI]: 86.1–97.1), and the NPV was 94% (95% CI: 87.4–97.8). Both the PPV and NPV of orchiectomy coding in the DNPR were 100% (97.5% CI: 92.9–100).Conclusion: We measured the validity of codes for GnRH agonist treatment and orchiectomies in the DNPR among prostate cancer patients and found high PPV and NPV. Thus, the DNPR remains a valuable tool for clinical epidemiological studies of GnRH agonist treatment and orchiectomies in the treatment of prostate cancer.Keywords: prostate cancer, orchiectomy, positive predictive value, negative predictive value
Six-month gonadotropin releasing hormone (GnRH) agonist depots provide efficacy, safety, convenience, and comfort
Crawford ED, Phillips JM
Cancer Management and Research , 2011, DOI: http://dx.doi.org/10.2147/CMAR.S12700
Abstract: nth gonadotropin releasing hormone (GnRH) agonist depots provide efficacy, safety, convenience, and comfort Review (3197) Total Article Views Authors: Crawford ED, Phillips JM Published Date July 2011 Volume 2011:3 Pages 201 - 209 DOI: http://dx.doi.org/10.2147/CMAR.S12700 E David Crawford, Jason M Phillips University of Colorado Health Sciences Center, Aurora, CO, USA Abstract: Two different 6-month GnRH agonist depot formulations approved for palliative treatment of advanced and metastatic prostate cancer in the United States – leuprolide acetate 45 mg and triptorelinpalmoate 22.5 mg – provide patients with efficacy and safety comparable to those of existing 1-, 3-, and 4-month GnRH agonist depots. However, the 6-month formulations can increase patient convenience, comfort, and compliance by reducing the number of physician visits and injections required. At the conclusion of their pivotal trials, the 6-month formulations demonstrated efficacy rates in achieving chemical castration (serum testosterone #50 ng/dL) that ranged between 93% and 99%. As with existing GnRH agonist depot formulations, hot flashes represented the most common adverse event reported in trials of 6-month leuprolide acetate or triptorelin. As such, these products may prove useful not only for their labeled indication, but also as adjuncts to other treatments such as radical prostatectomy, radiotherapy, and chemotherapy. We recommend further research, including head-to-head trials between the 6-month GnRH depots, to refine our understanding of these products.
Comparison of the ultrashort gonadotropin-releasing hormone agonist-antagonist protocol with microdose flare -up protocol in poor responders: a preliminary study  [cached]
Bülent Berker,Candan ?ltemir Duvan,Cemil Kaya,Ru?en Ayta?
Journal of the Turkish-German Gynecological Association , 2010,
Abstract: Objective: To determine the potential effect of the ultrashort gonadotropin-releasing hormone (GnRH) agonist/GnRH antagonist protocol versus the microdose GnRH agonist protocol in poor responders undergoing intracytoplasmic sperm injection (ICSI). Material and Methods: The patients in the Agonist-Antagonist Group (n=41) were administered the ultrashort GnRH-agonist/ antagonist protocol, while the patients in the Microdose Group (n=41) were stimulated according to the microdose flare-up protocol. The mean number of mature oocytes retrieved was the primary outcome measure. Fertilization rate, implantation rate per embryo and clinical pregnancy rates were secondary outcome measures. Results: There was no differenc between the mean number of mature oocytes retrieved in the two groups. There were also no statistical differences between the two groups in terms of peak serum E2 level, canceled cycles, endometrial thickness on hCG day, number of 2 pronucleus and number of embryos transferred. However, the total gonadotropin consumption and duration of stimulation were significantly higher with the Agonist-Antagonist Group compared with the Microdose Group. The implantation and clinical pregnancy rates were similar between the two groups. Conclusion: Despite the high dose of gonadotropin consumption and longer duration of stimulation with the ultrashort GnRH agonist/ antagonist protocol, it seems that the Agonist-Antagonist Protocol is not inferior to the microdose protocol in poor responders undergoing ICSI.
Hormonal induction of spawning in 4 species of frogs by coinjection with a gonadotropin-releasing hormone agonist and a dopamine antagonist
Vance L Trudeau, Gustavo M Somoza, Guillermo S Natale, Bruce Pauli, Jacqui Wignall, Paula Jackman, Ken Doe, Fredrick W Schueler
Reproductive Biology and Endocrinology , 2010, DOI: 10.1186/1477-7827-8-36
Abstract: Our new method is based on the injection of a combination of a gonadotropin-releasing hormone (GnRH) agonist and a dopamine antagonist. We have named this formulation AMPHIPLEX, which is derived from the combination of the words amphibian and amplexus. This name refers to the specific reproductive behavior of frogs when the male mounts and clasps the female to induce ovulation and to fertilize the eggs as they are laid.We describe the use of the method and demonstrate its applicability for captive breeding in 3 different anuran families. We tested several combinations of GnRH agonists with dopamine antagonists using Lithobates pipiens. The combination of des-Gly10, D-Ala6, Pro-LHRH (0.4 microrams/g body weight) and metoclopramide (10 micrograms/g BWt. MET) was most effective. It was used in-season, after short-term captivity and in frogs artificially hibernated under laboratory conditions. The AMPHIPLEX method was also effective in 3 Argentinian frogs, Ceratophrys ornata, Ceratophrys cranwelli and Odontophrynus americanus.Our approach offers some advantages over other hormonally-based techniques. Both sexes are injected only once and at the same time, reducing handling stress. AMPHIPLEX is a new reproductive management tool for captive breeding in Anura.The crisis of amphibian loss and the potential detrimental ecological impacts are globally recognized [1-7]. Nace and colleagues [8,9] were probably the first to indicate the need for captive breeding and domestication of amphibians. Currently, numerous captive breeding programs directly address the problem of the amphibian decline but significant challenges still remain [10,11]. It is well known that many anurans do not reproduce easily in captivity. They either suffer from confinement stress or critical environmental cues are missing in captivity, resulting in the inhibition of reproduction [12]. It is also important to note that our basic knowledge on the reproductive biology of many amphibians, especially neotrop
PROGESTERONE/ESTRADIOL RATIO IN THE LATE FOLLICULAR PHASE OF LONG GONADOTROPIN-RELEASING HORMONE AGONIST CYCLES DID NOT DIFFER BETWEEN CONCEIVED AND NOT-CONCEIVED WOMEN
L. Safdarian,F. Soltani Mohammadi,E. Rahimi
Acta Medica Iranica , 2008,
Abstract: There is a challenging debate on the effect of premature luteinization on the clinical outcome of ‘controlled ovarian hyperstimulation' (COH) using long ‘gonadotropin-releasing hormone agonist' (GnRHa) cycles. Premature luteinization is defined as late follicular progesterone/estradiol ratio more than 1 on the day of human chorionic gonadotropin (HCG) administration. We carried out a retrospective case-control study on 75 conceived cases versus 75 not-conceived control women, receiving long GnRHa cycles in their first cycle of treatment. Premature luteinization developed in 15% of the case group vs. 22% of the control group. Neither the late follicular progesterone/estradiol (P/E2) ratio was significantly different between the two groups, nor the day 3 follicle stimulating hormone (FSH), serum estradiol level on the HCG day, total amount of human menopausal gonadotropins ampoules, number of follicles, retrieved oocytes and transferred embryos. Endometrial thickness was significantly more in the pregnant women than in the non-pregnant group. Premature luteinization seems not to adversely affect the clinical outcome of COH.
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