The gonadotropin-releasing hormone agonist stimulation test--a sensitive predictor of performance in the flare-up in vitro fertilization cycle

Fertil Steril. 1991 Oct;56(4):711-7. doi: 10.1016/s0015-0282(16)54604-4.


Objective: To evaluate the initial versus early pattern of estradiol (E2) change after administration of a gonadotropin-releasing hormone agonist (GnRH-a), i.e., the GnRH-a stimulation test versus E2 pattern, respectively, as predictors of ovarian response and pregnancy in in vitro fertilization (IVF) patients stimulated with a flare-up protocol.

Design: Prospective study in a consecutive group of patients.

Setting: Tertiary care, institutional setting.

Patients: Two hundred twenty-eight patients entered and completed the study. The only patients excluded from study were those anticipated to have polycystic ovarian disease, those with a single ovary, or those with an ovarian cyst(s).

Interventions: Patients were stimulated with a GnRH-a flare-up protocol beginning on menstrual day 2.

Main outcome: Evaluation of the GnRH-a stimulation test and the E2 pattern as predictors of the number of mature oocytes retrieved and pregnancy.

Results: The GnRH-a stimulation test but not the E2 pattern was predictive of the number of mature oocytes retrieved (r = 0.53, P less than 1 X 10(-5) and pregnancy (chi 2 = 8.5, P = 0.04). The E2 pattern was predictive of the duration and number of ampules of gonadotropin required for stimulation.

Conclusion: The GnRH-a stimulation test is a sensitive predictor of performance in the flare-up IVF cycle.

MeSH terms

  • Adult
  • Cell Count
  • Embryo Transfer
  • Estradiol / blood*
  • Female
  • Fertilization in Vitro*
  • Follicle Stimulating Hormone / therapeutic use
  • Humans
  • Leuprolide*
  • Menotropins / therapeutic use
  • Oocytes / cytology
  • Ovary / physiology
  • Pregnancy
  • Prognosis
  • Prospective Studies


  • Estradiol
  • Menotropins
  • Follicle Stimulating Hormone
  • Leuprolide