Opposite responses to the addition of leuprolide acetate to human menopausal gonadotropin therapy in two perimenopausal women.

Leuprolide acetate was used to suppress the endogenous gonadotropins in order to prevent premature luteinization in two women under ovulation induction therapy. One patient had previously developed premature luteinization with clomiphene citrate, but consistently produced only one mature follicle with hMG therapy. However, when leuprolide acetate was started prior to hMG during an attempt for in vitro fertilization, it failed to stimulate even a mild rise in her serum estradiol. The other patient, who was not able to make a mature follicle with hMG alone because of premature luteinization, was enabled to make mature follicles with leuprolide therapy alone (without hMG). The exact mechanism for these totally different responses to leuprolide acetate in two perimenopausal women is not known.