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Presented by Hsin-Yang Li OB/GYN Dept., Taipei VGH

Presented by Hsin-Yang Li OB/GYN Dept., Taipei VGH. Premature LH Surge. Without the use of GnRH agonists or antagonists, premature LH surges occurs in 20% of gonadotropin stimulated cycles Premature LH surges induces atresia of follicles and exerts negative effects on the endometrium.

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Presented by Hsin-Yang Li OB/GYN Dept., Taipei VGH

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  1. Presented by Hsin-Yang Li OB/GYN Dept., Taipei VGH

  2. Premature LH Surge • Without the use of GnRH agonists or antagonists, premature LH surges occurs in 20% of gonadotropin stimulated cycles • Premature LH surges induces atresia of follicles and exerts negative effects on the endometrium

  3. Ways to Prevent Premature LH Surge in Controlled Ovarian Stimulation (Coccia ME., et. al., 2004)

  4. Most Commonly Used Protocols Long GnRH agonist 1. Slightly better pregnancy rate 2. More injections needed (Semin. Reprod. Med., 2002)

  5. Conclusion • GnRH antagonist regimens: 1) Endogenous FSH  during the early follicular phase  less synchronization of the follicular cohort  less mature oocytes 2) Endogenous LH  during the early follicular phase  slight progesterone   endometrial receptivity for the embryos  • Ways to improve GnRH antagonist regimens: 1) GnRH antagonist starts from FSH D1 2) OCP pretreatment x 18-28 d 2 d FSH  GnRH antagonist from FSH D5-6

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