Outcome of pregnancies inadvertently exposed to gonadotropin-releasing hormone analogues (GnRH-a) in early gestation

Abstract

In recent years the down-regulation of pituitary function by GnRH-a, before and during ovarian stimulation for IVF, has been widely used. When GnRH-a are commenced in the luteal phase, it is inevitable that some early human embryos will be exposed. To the best of our knowledge the total number of reported deliveries following exposure is less than 30. We report here a further nine uneventful pregnancies with successful neonatal outcomes and three early miscarriages. It is our belief that the favorable outcome in patients presented here, who inadvertently received GnRH-a in early unsuspected gestation, is related to the use of short-acting analogues (Buserelin nasal spray). This enabled immediate discontinuation of the drug when the presence of pregnancy was suspected. In addition, the routine administration of progesterone supplements is strongly recommended, regardless of the hormonal levels.