Vascular endothelial growth factor and inhibin A in follicular fluid of infertile patients who underwent in vitro fertilization with a gonadotropin-releasing hormone antagonist
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OBJECTIVE: To investigate the role of a gonadotropin-releasing hormone (GnRH) antagonist, minimal stimulation protocol, in the follicular fluid by measuring vascular endothelial growth factor (VEGF) and inhibin A. DESIGN: A cross-sectional prospective study. SETTING: Academic hospital. PATIENT(S): Seventy infertile patients submitted to in vitro fertilization (IVF). INTERVENTION(S): Patients were divided into two groups: group 1 (study) included 30 infertile patients subjected to IVF with a GnRH antagonist (minimal stimulation protocol); group 2 (control) included 40 infertile women who underwent natural-cycle IVF. MAIN OUTCOME MEASURE(S): Follicular fluid VEGF and inhibin A measurements. RESULT(S): The groups were comparable in terms of age, body mass index (BMI), and infertility characteristics. Moreover, follicular fluid VEGF and inhibin A concentrations (medians) were, respectively, 776 pg/ml (95% confidence interval [CI]: 775-1483) and 3,115 pg/mL (95% CI: 1,349-2,502) for group 1; 1,187.50 pg/mL (95% CI: 1,020-1,560) and 3,123.00 pg/mL (95% CI: 1,888-2,735) for group 2 (P>.05). CONCLUSION(S): We demonstrated that GnRH antagonist administration in infertile patients undergoing IVF did not alter the follicular fluid content of VEGF and inhibin A, and, probably, maturation and quality of oocytes as well. These results demonstrated the usefulness and safety of this drug on controlled ovarian stimulation (COS) protocols.
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