The effects of GnRH analogs on serum and follicular fluid leptin levels and pregnancy outcomes in short protocols of assisted reproductive technology.

ABSTRACT

OBJECTIVE: To determine serum and follicular leptin levels in patients using gonadotropin releasing hormone agonist and antagonist in Assisted Reproductive Technology short protocol cycles and to evaluate pregnancy outcomes. MATERIAL AND METHODS: Patients randomly selected to join assisted reproductive technology cycles during February 2004-July 2004 were enrolled in this study. Group 1 consisted of 21 patients receiving r FSH+ GnRH agonists, whereas Group 2 consisted of 34 patients who received r FSH +GnRH antagonists. During the ovulation induction period 5 serum samples were collected (induction day 1, day 3 or antagonist starting day, human chorionic hormone day, oocyte pickup day, and twelfth day of embryo transfer). Follicular fluid samples were collected to be evaluated for leptin, estradiol, prolactin and luteinizing hormone. RESULTS: There was no difference in age, basal FSH, basal LH, and basal E2 between groups. Serum leptin levels were similar in both groups. Also, when each group's serum leptin levels were evaluated according to the presence of pregnancy, there was no significant difference in both groups. When follicle leptin levels were evaluated according to the existence of pregnancy, in both groups the follicle leptin levels were lower in pregnant participants but this difference was not statistically significant. When obesity is defined as body mass index over 26.5, there is a correlation between obesity and leptin levels in Group 2. CONCLUSION: Our results have shown that both agonists and antagonists have similar efficacy and effect in poor responder women. Leptin levels in either groups, whether pregnant or non-pregnant were not statistically different. This result shows the need for more studies on leptin in infertility.