The perimenopausal patient in in vitro fertilization: the use of gonadotropin-releasing hormone. Academic Article uri icon

Overview

abstract

  • The perimenopause, incipient ovarian failure, is a major problem in stimulation failures during an in vitro fertilization program. This must be recognized as not necessarily related to age but also associated with adnexal inflammatory and operative processes. Although ovulation occurs uninterruptedly, the follicle-stimulating hormone in the early follicular phase is elevated and the luteinizing hormone is normal. Characteristically, there is no estradiol response to human menopausal gonadotropin therapy or a rapid response with a premature luteinizing hormone surge. These problems sometimes may be overcome with pulsatile intravenous gonadotropin-releasing hormone therapy, 5 or 10 micrograms/90 or 120 minutes. The major therapeutic problem is in the identification of a luteinizing hormone surge in these patients. Of eight women who were treated, two failed to respond with follicular maturation, three either had no oocytes aspirated from apparently postmature follicles or had postmature oocytes; and one had treatment cancelled due to ovulation. The four latter patients may have failed because of unrecognized ovulation. In the remaining two patients, one oocyte was fertilized and transferred, and one pregnancy occurred.

publication date

  • November 1, 1986

Research

keywords

  • Fertilization in Vitro
  • Menopause
  • Menopause, Premature
  • Ovarian Follicle
  • Pituitary Hormone-Releasing Hormones

Identity

Scopus Document Identifier

  • 0022979845

Digital Object Identifier (DOI)

  • 10.1016/s0015-0282(16)49829-8

PubMed ID

  • 3536604

Additional Document Info

volume

  • 46

issue

  • 5