Profound luteinizing hormone suppression after stopping the gonadotropin-releasing hormone-agonist leuprolide acetate

Abstract

Objective: To compare levels of serum LH during continued use of leuprolide acetate (LA) with levels during the first week after discontinuing LA.

Design: Prospective controlled study.

Setting: Clinical assisted conception program.

Patients: Women undergoing controlled ovarian stimulation for assisted conception were randomized to receive LA according to "short" or "ultrashort" protocols. The alternative protocol was used then in a second cycle. Each patient was thus her own control.

Main outcome measures: Serum LH over time.

Results: When LA was stopped after 5 days of administration, LH levels fell profoundly when compared with levels when LA was continued.

Conclusion: Loss of LH after stopping LA is likely to be clinically important in ovarian stimulation regimens that use pure FSH with LA in ultrashort protocols. The fall in LH lasts at least 1 week and may be explainable by persistent suppression of endogenous GnRH by LA during this time.