Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial.
Summary of "Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial."
OBJECTIVE:
To evaluate whether the incidence of luteinizing hormone (LH) rise is reduced by using a flexible compared with a fixed day-6 protocol of GnRH antagonist administration.
DESIGN:
Randomized controlled trial.
SETTING:
Tertiary university hospital. PATIENT(S): Patients undergoing in vitro fertilization (n = 146). INTERVENTION(S): Ovarian stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist cetrorelix (0.25 mg/d) was started either on day 6 of stimulation (fixed group) or when LH was >10 IU/L, and/or a follicle with mean diameter >12 mm was present, and/or serum E(2) was >150 pg/mL. Patient monitoring was initiated on day 3 of stimulation. MAIN OUTCOME MEASURE(S): Incidence of LH rise. RESULT(S): No statistically significant difference was observed between the flexible and fixed groups regarding the incidence of LH rise, which was lower in the flexible group (11.0% vs. 15.1%, difference -4.1%, 95% confidence interval -15.4% to +7.1%). No LH surges were observed in any of the patients studied. CONCLUSION(S): Flexible antagonist administration from day 3 onward does not appear to reduce the incidence of LH rises compared with fixed antagonist administration on day 6 of stimulation.
Affiliation
Unit for Human Reproduction, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Journal Details
This article was published in the following journal.
Name: Fertility and sterility
ISSN: 1556-5653
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20637457
- DOI: http://dx.doi.org/10.1016/j.fertnstert.2010.05.052
Medical and Biotech [MESH] Definitions
Leuprolide
A potent synthetic long-acting agonist of GONADOTROPIN-RELEASING HORMONE that regulates the synthesis and release of pituitary gonadotropins, LUTEINIZING HORMONE and FOLLICLE STIMULATING HORMONE.
Receptors, Corticotropin-releasing Hormone
Cell surface proteins that bind corticotropin-releasing hormone with high affinity and trigger intracellular changes which influence the behavior of cells. The corticotropin releasing-hormone receptors on anterior pituitary cells mediate the stimulation of corticotropin release by hypothalamic corticotropin releasing factor. The physiological consequence of activating corticotropin-releasing hormone receptors on central neurons is not well understood.
Gonadotropin-releasing Hormone
A decapeptide that stimulates the synthesis and secretion of both pituitary gonadotropins, LUTEINIZING HORMONE and FOLLICLE STIMULATING HORMONE. GnRH is produced by neurons in the septum PREOPTIC AREA of the HYPOTHALAMUS and released into the pituitary portal blood, leading to stimulation of GONADOTROPHS in the ANTERIOR PITUITARY GLAND.
Triptorelin
A potent synthetic long-acting agonist of GONADOTROPIN-RELEASING HORMONE with D-tryptophan substitution at residue 6.
Buserelin
A potent synthetic agonist of GONADOTROPIN-RELEASING HORMONE with D-serine substitution at residue 6, glycine10 deletion, and other modifications.
PubMed Articles
We previously discovered an orally active human gonadotropin-releasing hormone (GnRH) receptor antagonist, thieno[2,3-d]pyrimidine-2,4-dione derivative 1 (sufugolix). To reduce the cytochrome P450 (CY...
Tri-pronucleated zygotes may occur less frequently in luteinizing hormone activity-added cycles.
Objective. This study was performed to evaluate the association between adding luteinizing hormone (LH) activity and the incidence of tripronuclear (3PN) zygotes occurrence. Methods. The incidence of...
Mild/minimal stimulation for in vitro fertilization: an old idea that needs to be revisited.
Mild ovarian stimulation for in vitro fertilization usually refers to the use of low-dose gonadotropins in conjunction with a gonadotropin-releasing hormone (GnRH) antagonist whereas minimal stimulat...
Phylogenetic aspects of gonadotropin-inhibitory hormone and its homologs in vertebrates.
The decapeptide gonadotropin-releasing hormone (GnRH) is the primary factor responsible for the hypothalamic control of gonadotropin secretion in vertebrates, but a hypothalamic neuropeptide inhibitin...
Objective. To compare the efficacy and cost-effectiveness of extended high dose letrozole regimen/HPuFSH-gonadotropin releasing hormone antagonist (GnRHant) protocol with short low dose letrozole re...
Clinical Trials
Gonadotropin-Releasing Hormone (GnRH)-Antagonist Therapy in Rheumatoid Arthritis
The purpose of this study is to compare the safety and efficacy of gonadotropin-releasing hormone (GnRH) antagonist therapy versus placebo in patients with moderate to severe rheumatoid ar...
Men with Idiopathic Hypogonadotropic Hypogonadism (IHH) lack a hormone called gonadotropin releasing hormone (GnRH). This hormone is important for starting puberty, maintaining testosteron...
Agonist Gonadotropin-Releasing Hormone (GnRH) Versus Antagonist GnRH
Literature suggests that GnRH antagonists are comparatively more often used in cycles which have an unfavorable prior prognosis, and this protocol is an ideal one fo...
Gonadotropin-releasing Hormone Antagonist on Triggering Day: A Randomized Controlled Study
Gonadotropin-releasing hormone (GnRH) antagonists have been widely used for the prevention of premature luteinizing hormone (LH) surges during controlled ovarian hyperstimulation (COH) for...
This study was designed to evaluate the ability of gonadotropin releasing hormone (GnRh) agonist to prevent the rise of progesterone during controlled ovarian stimulation for in vitro fert...
