Effects of different doses of alarelin for inducing ovulation on luteal function

Abstract

Objective To explore the effects of different doses of gonadotropin releasing hormone agonist ( GnRH-a ) on luteal function and rates of pregnancy and abortion after ovulation induction and to provide theoretical support for clinical uses of the minimum effective dose of alarelin.Methods The clinical data on 124 women who received controlled ovarian stimulation ( COS ) during March 2011 to November 2011 were retrospectively analyzed.Human chorionic gonadotrophin( HCG ) or different doses of GnR Ha were used to induce ovulation as the diameter of dominate follicle was ≥ 18 mm.The women were randomly assigned to receive HCG of 10 000 IU for 43 cycles ( group A ),alarelin of 450 μ g for 38 cycles ( group B ),or alarelin of 150 μ g for 43 cycles ( group C ).Levels of estradiol,luteinizing hormone and progesterone on the day of induction and at mid-luteal phase,and rates of ovulation,clinical preguancy,abortion,and OHSS were compared among the three groups.Results Serum E2 level at mid-luteal phase was significantly lower in group B than in group A ( P＜ 0.01 ) while the ovulation rate was significantly higher in group B than in groups A and C ( P ＜ 0.05 and P ＜ 0.01 ) and it was higher in group A than in group C ( P ＜ 0.05 ).The age differed significantly among the three groups ( P ＜ 0.05 ).There were no significant differences among the three groups in endometrial thickness,serum levels of E2,LH,and P on the day of induction,levels of LH and P at mid-luteal phase,and rates of clinical pregnancy,abortion,and OHSS.Conclusions Alarclin of 150 μ g can effectively induces ovulation and has no obvious inhibitory effect on secretion of steroid hormone during mid-luteal phase.Alarelin of 450 μ g gains a higher ovulation rate but decreases E2 at mid-luteal phase,redueing the ineidence of OHSS.Supplement of exogenous estrogen and progesterone at mid-luteal phase is beneficial for elevating pregnancy rate and lowering obortion rate. Key words: GnRH-a; Ovulation induction; Ovarian hyperstimulation syndrome; HCG