Is within a doc out in that please who can describe me if- ganirelix & lupron, can be used simultaneously?
GnRH agonist + antagonist, what would crop up? If possible, could it have a refusal effect- greater risk of OHSS etc? Either may be enough to supress, but what would crop up if used together please?
Answer:
Combined treatment with the GnRH antagonists and agonists is a relatively trial concept.Research is still going on to confirm the effects and its not a well adopt technique. The protocol includes using gonadotrophin-releasing hormone (GnRH) antagonist , with the possibility to trigger a mid-cycle LH surge using a single bolus of GnRH agonist, reducing the risk of developing ovarian hyperstimulation syndrome (OHSS) within high responders and the arbitrariness of cycle cancellation. GnRH agonist effectively triggers an endogenous LH surge for final oocyte maturation after ganirelix treatment contained by stimulated cycles. GnRH antagonists competitively bind to pituitary LH and FSH receptors and lead to a prompt and profound suppression of gonadotropins.Due to the direct suppressive action, antagonist require a shorter command period of analogues and the lower state of pituitary suppression may result surrounded by a lower requirement of FSH.
The immediate reversibility of pituitary suppression after renunciation of the antagonist, provides opportunities for other stimulation strategies near reduced risk for ovarian hyperstimulation syndrome (OHSS: the final stage of follicular maturation can be triggered by a GnRH-agonist instead of the common used HCG,which may decrease the risk of OHSS. This risk will be even minimal if the antagonist is used in unconscious or minimal stimulated cycles).The potential of immediate repossession of suppression of endogenous LH secretion may lead to smaller quantity impairment of the luteal function. On the other hand agonists avoid premature LHsurge, synchronize follicular growth thus on the increase the quality of ovum collection, trim down OHSS and organise cycles with smaller number cancellation, the leutotrophic effect last longer and multiple corpus luteum can develop.
The efficacy and safety of such unsullied treatment regimen needs to be established within comparative randomized studies.
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