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A Study of Clinical Efficacy of GnRH Antagonist (Cetrorelix) Single and Multiple Dose Protocol for Controlled Ovarian Hyperstimulation  

Ko, Sang-Hyeon (Department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University)
Kim, Dong-Ho (Department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University)
Bae, Do-Hwan (Department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University)
Lee, Sang-Hoon (Department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University)
Publication Information
Clinical and Experimental Reproductive Medicine / v.29, no.4, 2002 , pp. 259-267 More about this Journal
Abstract
Objective: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. Materials and Method: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. Conclusions: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.
Keywords
GnRH antagonist; Single dose protocol; Multiple dose protocol;
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1 Yen SSC. Clinical applications of gonadotropin-releasing hormone and gonadotropin-releasing hormone analogs. Fertil Steril 1983; 39: 257-66   DOI
2 Lenton EA, Cooke ID, Hooper M, et al. In vitro fertilization in the natural cycle. Bailliere's Clin. Obstet Gynecol 1992; 6: 229-44   DOI   ScienceOn
3 Judith A F Huirne, Cornelis B Lambalk, Gonadotropin-releasing-hormone-receptor antagonists, The Lancet 2001; 358: 1793-803
4 Ng EH, Ho Pc. Use of gonadotrophin releasing hormone (GnRH) antagonist (cetrotide) during ovarian stimulation for in-vitro fertilization treatment: multiple doses and single dose. The Journal of Obstetrics and Gynaecology Research 2001; 27; 5: 261-5
5 Karande VC, Jones GS, Veeck L, Muasher SJ. High-dose FSH stimulation at the onset of the menstrual cycle does not suppress the IVF outcome of low-responder patients. Fertil Steril 1990; 53: 486-9   DOI   PUBMED
6 Van Hooff MHA, Alberda AT, Huisman GJ, et al. Doubling the human menopausal gonadotropin dose in the course of an in vitro fertilization treatment cycle in low responders: a randomized study. Hum Reprod 1993; 8: 369-73   DOI
7 Albano C, Platteau P, Devroey P. Gonadotropin releasing hormone antagonist: how good is the new hope? Curr Opin Obstet Gynecol 2001; 13:257-62
8 Erb K, Klipping C, Duijkers I, Pechstein B, Schueler A, Hermann R. Pharmacodynamic effects and plasma pharmacokinetics of single doses of cetrorelix acetate in healthy premenopausal women. Fertil Steril 2001; 75; 2: 316-23
9 Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, et al. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertil Steril 2000; 73: 314-20   DOI   ScienceOn
10 Diedrich K, Diedrich C, Santos E, et al. Suppression of the endogenous luteinizing hormone surge by the gonadotropin-releasing hormone antagonist Cetrorelix during ovarian stimulation. Hum Reprod 1994; 9: 788-91   DOI   PUBMED
11 Nikolettos N, AI-Hasani S, Felberbaum R, Demirel LC, Kupker W, Montzka P, et al. Gonadotropin-releasing hormone antagonist protocol: a novel method of ovarian stimulation in poor responders. European Journal of Obstetrics & Gynecology and Reproductive Biology 2001; 97: 202-7   DOI   ScienceOn
12 Diana BL. Applications for GnRH antagonists. Trends Endo Met 2001; 12: 238-40   DOI   ScienceOn
13 Albano C, Felberbaum R, Smitz J, et al. On behalf of the European Cetrorelix Study Group. Ovarian stimulation with HMG: results of a prospective randomized phase III European study comparing the luteinizing hormone-releasing hormone (LHRH) -antagonist cetrorelix and the LHRH-agonist buserelin. Hum Reprod 2000; 3: 526-31
14 Olivennes F, Frydman R. Friendly IVF: the way of the future? Hum Reprod 1998; 13; 5: 1121-4
15 Devroey P, Mannaerts B, Smitz J, Coelgh Bennink H, Van Steirteghem A. Clinical outcome of a pilot efficacy study on recombinant human FSH (Org 32489) combined with various GnRH agonist regimens. Hum Reprod 1994; 9: 1064-9   DOI   PUBMED
16 Olivennes F, Taieb J, Fanchin R, Selva J, Bouchard P, Frydman R. The single or dual administration of the gonadotropin-releasing hormone antagonist Cetrorelix in an in vitro fertilization-embryo transfer program. Fertil Steril 1994;62; 3: 468-76
17 Borm G, Mannaerts B. The European Orgalutran Study Group. Treatment with the gonadotrophin-releasing hormone antagonist ganirelix in women undergoing ovarian stimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized multicenter trial. Hum Reprod 2000; 15: 1490-8   DOI   ScienceOn
18 Albano C, Riethmuller-Winzen H, Smitz J, Van Steirteghem A, Camus M, Devroey P. Comparison of different doses of gonadotropin-releasing hormone antagonist Cetrorelix during controlled ovarian hyperstimulation. Fertil Steril 1997; 67; 5: 917-22
19 Bronson R. Embryo transfer and multiple gestation. Hum Reprod 1997; 12: 1605-6   DOI   ScienceOn
20 Olivennes F, Alvarez S, Bouchard P, Fanchin R, Salat-Barous J, Frydman R. the use of a GnRH antagonist (cetrorelix) in a single dose protocol in IVF-embryo transfer: a dose finding study of 3 versus 2 mg. Hum Reprod 1998; 13:2411-4   DOI
21 Hernandez ER. Embryo implantation: the rubicon for GnRH antagonist. Hum Reprod 2000; 15: 1211-6   DOI   ScienceOn
22 Claman P, Domingo M, Garner P, et al. Natural cycle in in-vitro fertilization -embryo transfer at the University of Ottawa: an inefficient therapy for tubal infertility. Fertil Steril 1993; 60: 298-302   DOI   PUBMED
23 Fauser BCJM, Paul D, Yen SSC, Gosden R, Crowley JR WF, Baird DT, et al. Minimal ovarian stimulation for IVF: appraisal of potential benefits and drawbacks. Hum Reprod 1999; 14; 11:2681-6
24 Smitz J, Van Den Abbeel E, Bollen N, Camus M, Devroey P, Toumaye H, et al. The effect of gonadotrophin-releasing hormone (GnRH) agonist in the follicular phase on in vitro fertilization outcome in normo-ovulatory women. Hum Reprod 1992; 7: 1098-102   DOI   PUBMED
25 Loumaye E. The control of endogenous secretion of LH by GnRH-a during ovarian hyperstimulation for in vitro fertilization and embryo transfer. Hum Reprod 1990;5: 357-76   DOI   PUBMED
26 Stranger JD, Yovich JL. Reduced in vitro fertilization of human oocytes from patients with raised basal luteinizing hormone levels during the follicular phase. Br J Obstet Gynaecol 1985; 92: 385-93   DOI