Ovarian reserve after prolonged down regulation of pituitary gland

ABSTRACT

The aim of this prospective study was to investigate the ovarian reserve and pituitary gland activity after prolonged down regulation with Goserelin for 2 months. Thirty patients with stage II-IV endometriosis received Goserelin [Zoladex] every 4 weeks]. The ovarian reserve was checked by measuring the anti-mullerian hormone [AMH] level every 4 weeks at the same time of checking the resting FSH, LH, and E2. The pituitary response to the Buserelin was assessed by measuring the FSH, LH and E2 one hour post 500ug Buserelin injection and before the scheduled Zoladex injection every 4 weeks. The ovarian reserve was not affected by prolonged down regulation with Goserelin. The pituitary gland achieved a profound degree of down regulation 4 weeks post Goserelin and maintained the same degree of down regulation following each subsequent injection. However the pituitary gland retains some degree of activity by responding to Buserelin and producing pulses of FSH and LH despite the profound down regulation