nafarelin and Abortion--Spontaneous

To compare the efficacy of a draw-back nafarelin acetate protocol with routine buserelin acetate administration for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).. Prospective clinical study.. Mie University School of Medicine, Tsu, Mie, Japan.. One hundred sixty-nine women treated with IVF and 183 women treated with ICSI.. Nafarelin acetate and buserelin acetate in ovarian hyperstimulation in IVF and ICSI were administered.. The concentrations of estradiol (E(2)), FSH, LH, gonadotropin dosages; the number of oocytes retrieved, oocytes fertilized, and embryos; and pregnancy rates.. A prospective study was conducted with 44 cycles for 34 couples with nafarelin acetate (group 1) and 47 cycles for 40 couples with buserelin acetate (group 2) with a long IVF protocol; 68 cycles for 46 couples with nafarelin acetate (group 3) and 56 cycles for 39 couples with buserelin acetate (group 4) with a short IVF protocol; 39 cycles for 32 couples with nafarelin acetate (group 5) and 50 cycles for 30 couples with buserelin acetate (group 6) with a long ICSI protocol; and 87 cycles for 60 couples with nafarelin acetate (group 7) and 81 cycles for 61 couples with buserelin acetate (group 8) with a short ICSI protocol. Patients were randomized to receive either full-dose nafarelin acetate (200 microg b.i.d.) treatment for 7 days followed by half-dose nafarelin acetate (200 microg daily) or buserelin acetate (300 microg t.i.d.). There were no statistically significant differences in baseline concentrations of E(2) and FSH, concentrations of E(2), P4, FSH, LH on hCG administration, gonadotropin dosage, the number of oocytes retrieved and embryos transferred, or pregnancy rates between groups 1 and 2, groups 3 and 4, groups 5 and 6, and groups 7 and 8.. Full-dose nafarelin acetate treatment for 7 days followed by half-dose nafarelin acetate ("draw-back" protocol) is an effective new protocol for IVF and ICSI.

Topics: Abortion, Spontaneous; Adult; Buserelin; Chorionic Gonadotropin; Embryo Implantation; Embryo Transfer; Endometrium; Estradiol; Female; Fertility Agents, Female; Fertilization in Vitro; Follicle Stimulating Hormone; Hormones; Humans; Luteinizing Hormone; Male; Nafarelin; Pregnancy; Progesterone; Prospective Studies; Sperm Injections, Intracytoplasmic; Time Factors

Implantation of pelleted agonistic analogs of luteinizing hormone-releasing hormone (LH-RH) into six pregnant baboons, ranging between 14 and 21 days after mating in individual animals, resulted in two abortions: one at 39 and the other at 67 days after mating. Plasma progesterone levels were low in treated animals through the 23rd day after mating, in spite of rising levels of plasma chorionic gonadotropin. Plasma levels of progesterone then rose rapidly to normal in five of six animals. Plasma estradiol levels were low from treatment on in the late-aborting animal but were normal until 5 days before delivery in the early abortant. The profile of circulating chorionic gonadotropin was truncated in treated animals, which may be the first indication of a paradoxical effect of LH-RH agonist on the trophoblast.

Topics: Abortion, Spontaneous; Animals; Chorionic Gonadotropin; Corpus Luteum; Drug Implants; Estradiol; Female; Gonadotropin-Releasing Hormone; Humans; Nafarelin; Papio; Placenta; Pregnancy; Pregnancy, Animal; Progesterone; Triptorelin Pamoate