Preferred treatment of infertile women older than 37 years of age who demonstrate premature luteinization in the first evaluation cycle

A L Lidor, Arie Lidor, S B Cohen, Shlomo B Cohen, D S Seidman, Daniel S. Seidman, Shlomo Mashiach, S. Mashiach, Shlomo Lipitz, S Lipitz, Mordechai Goldenberg, M Goldenberg
Fertility and sterility · 2000 · vol. 73(2) , pp. 321–324 · doi:10.1016/s0015-0282(99)00513-0 · PMID:10685536 · W2022608285
Non-randomised trial OA: closed CC0 ⤵ 1 in-corpus citation
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This study investigated the preferred treatment strategies for infertile women over 37 exhibiting premature luteinization during their initial evaluation cycle.

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Abstract

OBJECTIVE: To evaluate the efficacy of various treatments in abolishing premature luteinization in infertile women over 37 years old who are undergoing ovulation induction. DESIGN: Prospective, nonrandomized study. SETTING: Tertiary care medical clinic. PATIENT(S): Seventeen infertile women >37 years old in whom premature luteinization was detected during their evaluation (pretreatment) cycle. INTERVENTION(S): The patients underwent three consecutive treatment cycles with clomiphene citrate (group A), hMG (group B), and a GnRH agonist plus hMG (group C). MAIN OUTCOME MEASURE(S): Premature luteinization, defined as a progesterone/E2 ratio of >1 on the day of hCG administration. RESULT(S): Fifteen (88%) of the 17 patients in group A and 13 (76%) of the 17 patients in group B demonstrated premature luteinization. In contrast, only 1 (6%) of the 17 patients in group C had a progesterone/E2 ratio of >1 on the day of hCG administration. The mean (+/-SD) E2 level on the day of hCG administration was significantly higher in group C (1.236 +/- 772.7 pg/mL) than in group A (214.02 +/- 104.46 pg/mL) or group B (412.5 +/- 337 pg/mL). CONCLUSION(S): Pituitary desensitization with a GnRH agonist in conjunction with hMG may be of benefit for older infertile women who demonstrate early luteinization in their first evaluation cycle.

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MeSH descriptors

Follicular Phase Follicular Phase Infertility, Female Ovulation Induction Adult Chorionic Gonadotropin Chorionic Gonadotropin Clomiphene Clomiphene Female Follicular Phase Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Humans Infertility, Female Maternal Age Menotropins Menotropins Middle Aged Ovarian Follicle

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