nafarelin and Ovarian-Cysts

Down-regulation in assisted reproduction treatment cycles is monitored by suppression of ovarian/pituitary hormones and/or measurement of endometrial thickness.. This prospective longitudinal study reports on utero-ovarian characteristics of pituitary desensitization. A total of 75 patients were recruited; 32 had IVF treatment, 20 frozen--thawed embryo transfer cycles and 23 patients were recipients of donated oocytes. All received early follicular-phase down-regulation and had colour flow Doppler velocimetry of the utero-ovarian arteries < or =3 days before the start of menses and after 21 days of gonadotrophin-releasing hormone (GnRH) analogue treatment. Ovarian volume, endometrial thickness, pituitary and ovarian hormone concentrations were recorded at each scan.. Significant changes (P < 0.05) were noted in these and utero-ovarian vasculature during the down-regulation period, with good correlation between resistance index and oestradiol estimations. Neither the type of GnRH analogue nor age influenced the changes in utero-ovarian blood flow. Ovarian artery resistance index was the best Doppler predictor for pituitary suppression and a mean discriminatory cut-off value of 0.867 +/- 0.025 was found to have the highest specificity and positive predictive value.. This study has, for the first time, defined cut-off values for satisfactory pituitary suppression with high positive predictive value and specificity in an early follicular phase long protocol of GnRH analogue down-regulation using colour flow Doppler.

Topics: Adult; Aging; Arteries; Blood Flow Velocity; Buserelin; Embryo Transfer; Endometrium; Estradiol; Female; Fertilization in Vitro; Follicular Phase; Gonadotropin-Releasing Hormone; Humans; Longitudinal Studies; Nafarelin; Oocyte Donation; Ovarian Cysts; Ovary; Pituitary Gland; Prospective Studies; Pulsatile Flow; ROC Curve; Ultrasonography, Doppler, Color; Ultrasonography, Doppler, Pulsed; Uterus; Vascular Resistance

A total of 100 patients with disseminated forms of external genital endometriosis were administered multiple-modality treatment including surgery and antihormone therapy. Twenty patients with the same diagnosis were controls and subjected to surgery alone. The results of treatment assessed on the basis of analysis of the clinical course of the disease, status of the menstrual and generative functions, drug effects on the central nervous system, hormonal status, and target organs (mammary glands and osseous tissue) evidence good potentialities of laparoscopy and high efficacy of subsequent therapy with antihormones in the treatment of patients with grave forms of endometriosis.

Topics: Adult; Chemotherapy, Adjuvant; Delayed-Action Preparations; Drug Evaluation; Endometriosis; Female; Follow-Up Studies; Gestrinone; Gonadotropin-Releasing Hormone; Hormones; Humans; Laparoscopy; Nafarelin; Ovarian Cysts; Postoperative Care; Progesterone Congeners; Recurrence; Triptorelin Pamoate