Prevention of follicular maturation in endometriosis by subcutaneous infusion of luteinizing hormone-releasing hormone agonist started in the luteal phase
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Subcutaneous infusion of a GnRH agonist initiated during the luteal phase effectively prevented follicular maturation, indicating a potential therapeutic strategy for endometriosis.
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Abstract
Six endometriosis patients were treated with continuous subcutaneous (SC) infusion of a luteinizing hormone-releasing hormone (LH-RH) agonist using an external osmotic minipump system. Serum estradiol (E2) was suppressed into the menopausal range within 1 to 2 weeks of treatment started between days 9 and 12 after ovulation. The down-regulation of the pituitary-ovarian axis was maintained for the 24 weeks of treatment. Endometriosis symptoms were relieved during the treatment. At control laparoscopy, implants had regressed markedly and some adhesions had softened, accounting for a significant 58.3% reduction in the mean total American Fertility Society score. Ovulation returned within 14 to 38 days. Four infertile women became pregnant within 2 to 5 months after cessation of treatment. Frequent side effects were hot flushes, and decreased vaginal secretion and libido. There were no significant changes in laboratory blood tests, including cholesterol. The urinary calcium/creatinine ratio increased during the treatment. Thus, starting the treatment in the luteal phase prevented initial follicular stimulation. A better efficacy of treatment would be achieved by the release of an LH-RH agonist at a constant daily rate.
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Cited by (15)
- Gonadotropin releasing hormone agonists: Expanding vistas 2011
- GnRH agonists and add‐back therapy: is there a perfect combination? 1998
- Cyclic and individualized administration of gonadotropin-releasing hormone agonists plus progestogens: An alternative protocol for contraception 1997
- Endocrine effects of GnRH analogue with low‐dose hormone replacement therapy in women with endometriosis 1995
- Estrogenic suppression by different administration schedules of goserelin depot for treatment of endometriosis 1993
- Gonadotrophin releasing hormone agonist suppressive treatment of ovarian function decreases serum LH‐<i>β</i> and bloactive LH but maintains elevated levels of LH‐<i>α</i> 1991
- Cholesterol fractions and apolipoproteins during endometriosis treatment by a gonadotrophin releasing hormone (GnRH) agonist implant or by danazol 1991
- Efficacy and Endocrine Effects of Medical Treatment of Endometriosis 1991
- Basic and clinical aspects of GnRH‐agonists in reproduction 1990
- Gonadotrophin releasing hormone agonist (buserelin) in the treatment of endometriosis: changes in the extent of the disease and in CA 125 serum levels after 6‐month therapy 1990
- Long-term suppression of ovarian function by a luteinizing-hormone releasing hormone agonist implant in patients with endometriosis 1990
- Buserelin 1990
- Serum Concentration and Urinary Excretion of the Luteinizing Hormone-Releasing Hormone Agonist Buserelin in Patients with Endometriosis 1989
- GnRH Analogues in the Treatment of Endometriosis 1989
- Escape from the down-regulation of the pituitary-ovarian axis following decreased infusion of luteinizing hormone-releasing hormone agonist 1988
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