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Chris Anne Raymond, PhD

JAMA. 1988;259(14):2060-2063.

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ON THE HORIZON are several developments that, if widely implemented, could presage higher and more predictable birth rates at in vitro fertilization clinics. Some of those discussed at the last meeting of the American Fertility Society in Reno, Nev, included the following:

• Predictors of response to follicular stimulation. Research conducted at the Jones Institute for Reproductive Medicine at the Eastern Virginia Medical School, Norfolk, suggests that women who respond to exogenous gonadotropins with a very high surge of either luteinizing hormone (LH) or folliclestimulating hormone (FSH) will not conceive. By this criterion, about 60% of women are nonresponders. These women, once identified, may avoid stimulation failure by being pretreated with gonadotropin releasing hormone (Gn-RH) agonists.

• Synthetic Gn-RH agonists. Gn-RH agonists bind tightly to receptors in the pituitary gland. Initially, this stimulates the pituitary to release FSH and LH. Continuous administration, however, suppresses endogenous gonadotropin levels, through a process . . . [Full Text PDF of this Article]

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