Author/Editor		Vogler, A
Title		Vpliv ovarijskih cist med uporabo GnRH analogov na uspeh postopka zunajtelesne oploditve
Translated title		The influence of ovarian cyst during GnRH analogue use of in vitro fertilization outcome
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. 2
Publication year		1995
Volume		str. 81-3
Language		slo
Abstract		Background. A well known complication of gonadotropin releasing hormone analogues (GnRHa) administration is ovarian cyst formation. There are at least two main hypothesis about etiology: direct action of GnRHa on the ovary and an indirect effect of GnRHa because of so-called "flare up" mechanism. In the present work the effect of ovarian cyst formation after GnRHa administration in the Ljubljana IVF program was studied. Methods. 207 IVF patients where GnRHa use was indicated were followed. All of the patients were given 0.6 mg of Buserelin s. c. on the day 22 of the cycle for 14 days. The effectiveness of GnRHa was examined on the day 15 by the level of hypophiseal desensibilisation. Criteria for a successful inhibition of gonadotropin secretion are: follicles no larger than 5 mm in diameter and serum estradiol (E2) level equal or lower than 0.05 nmol/L. At that time in 20 (9.66 percent) patients ovarian cysts (group "A") were detected, while in others GnRHa application was successful. The following data were compared between both groups: age, indications for IVF, number of oocytes retrived, no. of embryos transferred, E2 level on the day of human chorionic gonadotropin (HCG) administration and no. of pregnancies per puncture and per embryo-transfer (ET). Results. Mean age, indications for the IVF, E2 level, number of oocytes retrived and embryos transferred were very similar in both groups of patients. Pregnancies achieved per puncture and per ET were 5.00 percent and 9.09 percent in group "A" and 14.44 percent and 20.93 percent in group "B" respectively. The difference is quite remarkable but statistic analysis shows no significant difference. Conclusions. The present study shows that ovarian cyst formation as a complication of GnRHa therapy does not impair the outcome of IVF-ET procedure and therefore cycles should not be cancelled.
Summary		Izhodišča. Tvorba ovarijskih cist kot zaplet dajanja analogov hormona sproščevalca gonadotropinov (GnRHa) je dobro znana in relativno pogosta. Glede etiologije prevladujeta dve hipotezi: neposreden učinek GnRHa na ovarij in posreden učinek zaradi začetnega porasta gonadotropinov ("flare up"). Z našo raziskavo smo ugotavljali vpliv ovarijskih cist kot zaplet dajanja GnRHa na postopek zunajtelesne oploditve(IVF) na Ginekološki kliniki v Ljubljani. Metode. V raziskavi smo obravnavali 207 bolnic v postopku zunajtelesne oploditve, ki so prejemale GnRHa: Buserelin 0,6 ml s. c. dnevno 14 dni od 22. dne menstruacijskega ciklusa. Učinek GnRHa smo preverjali 15 dan z ugotavljanjem stopnje hipofizne gonadotropinske sekrecije so: folikli manjši do 5 mm in serumski estradiol (E2) enak ali nižji kot 0,05 nmol/L. V tem času smo pri 20 bolnicah odkrili ovarijske ciste (skupina "A"), pri ostalih pa je bila aplikacija GnRHa uspešna. Med obema skupinama bolnic smo primerjali: starost, indikacije za IVF, število dobljenih oocitov, število embrijev, nivo E2 na dan aplikacije horionskega gonadotropina (HCG) in stopnjo zanositve glede na punkcijo in embrio transfer (ET). Rezultati. Povprečna starost, indikacije, raven E2 v serumu, število oocitov in embrijev so bili podobni pri obeh skupinah bolnic. Stopnja zanositve je bila pri skupini "A" 5,0 odst. na punkcijo in 9,09 odst. na ET, pri skupini "B" pa 14,44 odst. in 20,93 odst.. Razlika je bila dokaj velika, vendar ni statistično značilna. Zaključki. S to raziskavo smo ugotovili, da nastanek ovarijskih cist kot zaplet dajanja GnRHa ne zmanjša uspešnosti IVF postopka, tako da postopka zaradi cist ni potrebno prekiniti.
Descriptors		FERTILIZATION IN VITRO OVULATION INDUCTION GONADORELIN OVARIAN CYSTS EMBRYO TRANSFER OOCYTES