چكيده لاتين :
Long protocol of Gonadotropin-Releasing Hormone-analougue (GnRH-a) can result in
the formation of ovarian cyst by the transient initial stimulatory effect which increases the
levels of both foIlicle-stimulating hormone (FSH) and luteinizing hormone (LH). These cysts
require surgical drainage or result in poor ovarian response. Ovarian cyst formation can be
prevented by taking oral contraceptives (OCs) which suppress LH and FSH after initiation of
GnRH-a therapy. This study was designed to investigate ovarian cyst formation during therapy
with depot formulation of GnRH-a and also the effect of taking (OCs) before starting the
treatment with depot formulation of GnRH-a, on the formation of ovarian cyst, implantation
and pregnancy rate in assisted reproductive tecnique (ART) cycles. Fifty four infertile women
who were candidate for ART, underwent two treatment protocols in a prospective randomized
trial: (a) OC+HMG+diphereline and (b) HMG+diphereline. In group (a) patients were
pretreated with OC for 14 days starting from the first day of mensturation and on the day 14
received 3.75 mg 1M depot diphereline. Patients in group (b) received 3.75 mg diphereline
by intramuscular injection on the second day of menstruation. Sonography was performed on
the first day of menstruation and also 7 and 14 days after diphereline injection. Ovarian cyst
incidence, gonadotropin consumption, foIlicular growth, implantation rate and pregnancy in
the two groups were studied. No ovarian cyst with diameter over 26 mm was developed with
depot formulation of GnRH-a in any of the two groups (a and b). There was no significant
difference between the two groups in the foIlicular growth (9.2(PLUS-MINUS)2.1 and 9.4(PLUS-MINUS)2.9), number of
oocyte (5.0(PLUS-MINUS)2.8 and 5.4(PLUS-MINUS)5.7), implantation rate (0.02(PLUS-MINUS)0.08 and 0.03(PLUS-MINUS)0.10) and pregnancy
rate (0.09 and 0.11 ). We divided the patients into two groups based on their ages: (20-34) and
((GREATER THAN OR EQUAL)35). It showed no significant difference in the gonadotropin consumption, mean number of
follicles and mean number of embryos in groups (a and b) based on their ages. No ovarian cyst
developed with depot formulation of GnRH-a. So, in women with a history of ovarian cyst
formation in previous cycles depot form ofGnRH-a may be considered. Pretreatment with OCs
during therapy with depot formulation ofGnRH-a and gonadotropin didnיt increase the number
of oocyte, implantation rate and pregnancy.
