Abstract
It has been theorized that the administration of human menopausal gonadotropin (hMG) in consecutive menstrual cycles will result in a poor follicular response in the second cycle. To examine this, 50 women undergoing ovulation induction in two consecutive cycles were assessed, using in each the same induction regimen during the initial 5 days. The remainder of each cycle was individualized according to their response. Nine women were anovulatory, 19 were oligoovulatory, and 22 ovulated regularly in unstimulated cycles. In repeat cycles only 3 of 50 had poor follicular development and did not receive human chorionic gonadotropin (hCG); all were anovulatory. Forty-two of 50 of the first cycles had continually rising estradiol (E2), while 43 of 47 of the second cycles had rising E2 patterns. Grouping the peak E2 prior to hCG in the ranges <300, 300–699, 700–1099, and ⩾1100 pg/ml, peaks in the second cycle were similar in 25 of 50, lower in 16, and higher in 9. Only 3 of 9 anovulatory women had similar peaks, as compared to 22 of 41 of the oligoovulatory and regularly ovulating women. Comparing the second to the first cycle, the day of hCG was within 1 day in 28 of 50 women, 2 or more days less than the first cycle in 6, and 2 or more days greater than the first cycle in 11. We conclude that in a successive cycle of ovulation induction (i) the follicular response is impaired in anovulatory women, but (ii) in oligoovulatory or regularly ovulating women, clinically significant differences in the estradiol response do not occur.
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Diamond MP, Wentz AC: Ovulation induction with human menopausal gonadotropins. Obstet Gynecol Survey 1986;41:480
Garcia JE, Jones GS, Acosta AA, Wright J: Human menopausal gonadotropin/human chorionic gonadotropin follicular maturation for oocyte aspiration: Phase 1, 1981. Fertil Steril 1982;39:26
Laufer N, DeCherney AH, Haseltine FP, Polan ML, Mezer HC, Dlugi AM, Sweeney D, Nero F, Naftolin F: The use of high-dose human menopausal gonadotropin in an in vitro fertilization program. Fertil Steril 1983;40:734
Diamond MP, Wentz AC, Herbert CM, Pittaway DE, Maxson WS, Daniell JF: One ovary or two: Difference in ovulation induction, estradiol level, and follicular development in a program for in vitro fertilization. Fertil Steril 1984;41:524–519
Hodgen GD: The dominant ovarian follicle. Fertil Steril 1982;38:281
diZerega G, Goebelsmann U, Nakamura R: Identification of proteins(s) secreted by the preovulatory ovary which suppresses the follicle response to gonadotropins. J Clin Endocrinol Metab 1982;54:1091
diZerega G, Marrs R, Roche P, Campeau J, Kling O: Identification of proteins in pooled human follicular fluid which suppress follicular response to gonadotropins. J Clin Endocrinol Metab 1983;56:35
diZerega G, Marrs R, Campeau J, Kling O: Human granulosa cell secretion of protein(s) which suppress follicular response to gonadotropins. J Clin Endocrinol Metab 1983;56:147
Marut EL, Hodgen GD: Asymmetric secretion of principal ovarian venous steroids in the primate luteal phase. Steroids 1982;39:461
diZerega G, Hodgen G: The interovarian progesterone gradient: A spatial and temporal regulator of folliculogenesis in the primate ovarian cycle. J Clin Endocrinol Metab 1982;54:495
Hsuch AJW, Adashi EY, Jones BC, Welsh TH Jr: Hormonal regulation of the differentiation of cultured ovarian granulosa cells. Endocrine Rev 1984;5:76
Jones HW Jr, Acosta AA, Andrews MC, Garcia JE, Jones GS, Mayer J, McDowell JS, Rosenwaks Z, Sandow BA, Veeck LL, Wilkes CA: Three years of in vitro fertilization at Norfolk. Fertil Steril 1984;42:826
Diamond MP, Wentz AC, Vaughn WK, Webster BW, Herbert CM, Osteen KG, Maxson WS: Outcome of successive cycles of ovulation induction in the same individual. Fertil Steril 1985;43:369
Jones GS, Acosta AA, Garcia JE, Bernardus RE, Rosenwaks Z: The effect of follicle-stimulating hormone without additional luteinizing hormone on follicular stimulation and oocyte development in normal ovulatory women. Fertil Steril 1985;43:696
Lyles R, Gibbons WE, Dodson MG, Poindexter AN, Young RL, Rossavik IK, Findley WE: Characterization and response of women undergoing repeat cycles of ovulation induction in an in vitro fertilization and embryo transfer program. Fertil Steril 1985;44:832
Zelesnik AJ, Hillier SG: The role of gonadotropins in the selection of the preovulatory follicle. Clin Obstet Gynecol 1984;27:927
Laufer N, Botero-Ruiz W, DeCherney AH, Haseltine FP, Polan ML, Behrman HR: Gonadotropin and prolactin levels in follicular fluid of human ova successfully fertilized in vitro. J Clin Endocrinol Metab 1984;58–430
Botero-Ruiz W, Laufer N, DeCherney AH, Polan ML, Haseltine FP, Behrman HR: The relationship between follicular fluid steroid concentration and successful fertilization of human oocytes in vitro. Fertil Steril 1984;41:820
Crooke AC, Sutaria UD, Bertrand PV: Comparison of daily with twice-weekly injections of follicle-stimulating hormone for treatment of failure of ovulation. Am J Obstet Gynecol 1971;111:405
Welner SL, Polan ML, Graebe RA, Barnea E, DeCherney AH: The use of empiric pergonal therapy in patients with infertility of unknown origin. 41st Annual Meeting, American Fertility Society, Chicago, IL, Sept 1985
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Diamond, M.P., DeCherney, A.H., Hill, G.A. et al. Response to repetitive cycles of ovulation induction in the same women. J Assist Reprod Genet 4, 251–255 (1987). https://doi.org/10.1007/BF01555198
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DOI: https://doi.org/10.1007/BF01555198