Comparison of Clinical Efficacy between a Single Administration of Long-Acting Gonadotrophin-Releasing Hormone Agonist (GnRHa) and Daily Administrations of Short-Acting GnRHa in In Vitro Fertilization-Embryo Transfer Cycles

This study was aimed to evaluate the efficacy of a single administration of long-acting gonadotrophin-releasing hormone agonist (GnRHa) as compared with daily administrations of short-acting GnRHa in controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET) cycles. The mean dosage of recombinant follicle-stimulating hormone (rFSH) required for COH (2,354.5+/-244.2 vs. 2,012.5+/-626.1 IU) and the rFSH dosage per retrieved oocyte (336.7+/-230.4 vs. 292.1+/-540.4 IU) were significantly higher in the long-acting GnRHa group (N= 22) than those in the short-acting GnRHa group (N=28) (p<0.05). However, the mean number of visit to the hospital that was required before ovum pick-up (3.3+/-0.5 vs. 22.2+/-2.0) and the frequency of injecting GnRHa and rFSH (12.8+/-1.2 vs. 33.5+/- 3.5) were significantly decreased in the long-acting GnRHa group (p<0.0001). The clinical pregnancy rate, implantation rate, and early pregnancy loss rate were not significantly different between the 2 groups. So, we suggest that a single administration of long-acting GnRHa is a useful alternative for improving patient's convenience with clinical outcomes comparable to daily administrations of short-acting GnRHa in COH for IVF-ET cycles.

Treatment of endometriosis with gonadotropin releasing hormone agonist (buserelin).

The results of treatment of endometriosis with intranasal buserelin is convincing. The drug effectively suppresses serum estradiol to the menopausal level. Clinical improvement and regression of endometriotic lesions were observed during treatment. Thus, buserelin offers an alternative medical treatment of endometriosis. Further studies of the effects of GnRH agonist on bone mass are needed.

Utilizacion de un analogo de LH-RH subcutaneo e intranasal en el tratamiento de niñas con pubertad precoz central / Use of a LH-RH analogue subcutaneously and intranasally in the treatment of girls with central precocious puberty

Se presenta la experiencia en 5 pacientes de sexo feminino. Sus edades cronológicas oscilaron entre 1,3 y 6,8 años, con edades óseas entre 2,3 y 11,6 años. Las dosis empleadas fueron: 25 microng/kg/dSC y posteriormente 1200 microng/dIN. En 2 niñas se administraron 159 mg de medroxiprogesterona previo al análogo y una semana después. En un caso, se comenzó por via IN por reacción alérgica local a la inyección SC. El tratamiento osciló entre 3 y 21 meses. Se obtuvo una regreión completa del desarrollo mamario en 4 pacientes y parcial en 1. En 4/5 casos se pudo valorar la velocidad de crecimiento anual, observándose una reducción entre el 40 y 55% vs. pretratamiento, asociada a desaceleración de la maduración ósea y a un incremento entre 2 y 4,5cm en la predicción de talla adulta. Durante la terapéutica se obtuvo una reducción de los niveles de LH, FSH y estradiol hasta valores prepuberales, así como una ausencia de respuesta en la prueba de LH-RH. Concluímos que el Buserelin constituiría en recurso altamente efectivo en el tratamiento de esta patoloía, siendo, al igual que otros análogos del LH-RH, recursos útiles que mejorarian la predicción de talla final