The impact of a gonadotropin-releasing hormone antagonist on gonadotropin ovulation induction cycles in women with polycystic ovary syndrome: a prospective randomized study.

Abstract

OBJECTIVE:

To evaluate the effect of the gonadotropin-releasing hormone antagonist Ganirelix on gonadotropin ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS).

DESIGN:

Prospective, randomized, controlled study.

SETTING:

Academic infertility center.

PATIENT(S):

Ninety-eight anovulatory women with PCOS undergoing 154 gonadotropin OI cycles.

INTERVENTION(S):

Patients were treated with recombinant FSH alone (group 1) or in conjunction with Ganirelix when the leading follicle was ≥13 mm (group 2) versus from the beginning of stimulation (group 3), followed by IUI.

MAIN OUTCOME MEASURE(S):

Per cycle clinical pregnancy rate (CPR), live-birth rate (LBR), total gonadotropin dose, days of stimulation, serum LH and peak E2, and premature luteinization rate.

RESULT(S):

Data are suggestive of improved CPR in group 2 versus group 1 (33% vs. 19%) and LBR (35% vs. 20%) but not significantly different. Premature luteinization was highest in group 1 (21% vs. 1.8% in group 2 and 2.1% in group 3). Group 3 had the highest cancellation rate and cost without improving CPR and LBR. No differences were noted in peak serum E2, total gonadotropin dose, or days of stimulation.

CONCLUSION(S):

Adding Ganirelix in a flexible protocol to gonadotropin OI cycles in women with PCOS may be beneficial by decreasing premature luteinization.

• Authors: Laurel A Stadtmauer, Abbaa Sarhan, E Hakan Duran, Hind Beydoun, Silvina Bocca, Beth Pultz, Sergio Oehninger
• Journal: Fertility and sterility (Fertil Steril) Vol. 95 Issue 1 Pg. 216-20 (Jan 2011) ISSN: 1556-5653 [Electronic] United States
• PMID: 20594551 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Chemical References

• Gonadotropins
• Hormone Antagonists
• Recombinant Proteins
• Gonadotropin-Releasing Hormone
• Luteinizing Hormone
• Follicle Stimulating Hormone
• ganirelix

Topics

• Adult
• Drug Therapy, Combination
• Female
• Follicle Stimulating Hormone (administration & dosage)
• Gonadotropin-Releasing Hormone (administration & dosage, analogs & derivatives, antagonists & inhibitors)
• Gonadotropins (administration & dosage)
• Hormone Antagonists (administration & dosage)
• Humans
• Infertility, Female (drug therapy, physiopathology)
• Luteinizing Hormone (blood)
• Ovulation Induction (methods)
• Polycystic Ovary Syndrome (drug therapy, physiopathology)
• Pregnancy
• Pregnancy Rate
• Prospective Studies
• Recombinant Proteins (administration & dosage)