THE USE OF GONADOTROPIN RELEASING HORMON ANTAGONIST IN CYCLES STIMULATED WITH CLOMIFEN CITRATE AND GONADOTROPHINS IN ASSISTED REPRODUCTION PROCEDURES
Keywords:
clomifen citrate, gonadotrophins, antagonist of gonadotrophin releasing hormons, assisted reproductive techniquesAbstract
Background. The antagonists of gonadotrophin releasing hormon (ant GnRh) offer possibilities of using clomiphene citrate (CC) in ovarian stimulation regimens, because at the beginning of the controlled ovarian stimulation cycle the pituitary is fully susceptible to GnRH pulses.
The aim of our study was to asses the succes of cycles stimulated with CC, gonadotrophins and ant GnRh.
Methods. 40 cycles stimulated with CC, gonadotrophins and ant GnRH (first group) were analysed and compared with 226 cycles stimulated with gonadotrophins and ant GnRH (second group). We compared the mean number of ampouls of gonadotrophins, the administration of ampouls in days, the mean number of oocytes, the percent of normal fertilisation, the pregnancy rate per transfer and the pregnancy rate per cycle. The diffrent values of the variables were compared using Chi-square test and t-test.
Results. The mean number of ampoules of gonadotrophines used and the mean number of days of stimulation were statisticaly significant lower in the first group of patients. The diferences in the mean number of oocytes, the percent of normal fertilisation, the pregnancy rate per transfer and the pregnancy rate per cycle between the groups were not statisticaly significant.
Conclusions. Considering of our results, we can conclude that ovarian stimulation regimen with CC, gonadotrophins and ant GnRH offer comparable results with regimens with gonadotrophins and ant GnRH with lower number of ampoules used and shorter period of administration of gonadotrophins
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Engel JB, Ludwig M, Felberbaum R, Albano C, Devroey P, Diedrich K. Use of cetrorelix in combination with clomiphene citrate and gonadotrophins: a suitable approach to »friendly IVF«? Hum Reprod 2002; 17: 2022–6.
Hernandez ER. Embryo implantation and GnRH antagonists. Embryo implantation: the Rubicon for GnRH antagonists. Hum Reprod 2000; 15: 1211–6.
Olivennes F et al. GnRH antagonists in single-dose applications. Hum Reprod 2000; 6: 313–7.
Diedrich K, Diedrich E, Santos E et al. Suppression of the endogenous LHsurge by the LH-RH antagonist Cetrorelix during ovarian stimulation. Hum Reprod 1994; 9: 788–91.
Albano C, Smitz J, Camus M. Comparison of different doses of gonadotropinreleasing hormone antagonist Cetrorelix during controlled ovarian hyperstimulation. Fertil Steril 1999; 67: 917–22.
Leroy I, d’Acremont MF, Brailly-Tabard S et al. A single injection of gonadotropin-releasing hormone (LH-RH) antagonist (Cetrorelix) postpones the luteinizing hormone (LH) surge: further evidence of the role of LH-RH during the LH surge. Fertil Steril 1995; 62: 461–7.
Olivennes F, Fanchin R, Bouchard P et al. The single or dual administration of the gonadotrophin-releasing hormone antagonist Cetrorelix in an in vitro fertilization-embryo transfer program. Fertil Steril 1994; 62: 468–76.
Tavaniotou A, Albano C, Smitz J, Devroey P. Effect of clomiphene citrate on follicular and luteal phase luteinizing hormone concetrations in in vitro fertilization cycles stimulated with gonadotropins and gonadotropin-relasing hormone antagonist. Fertil Sterill 2002; 77: 733–7.
Craft I, Gorgy A, Hill J, Menon D, Podsiadly B. Will GnRH antagonist provide new hope for patients considered »difficult responders« to GnRH agonist protocols? Hum Reprod 1999; 14: 2959–62.
Williams SC, Gibbons WE, Muasher SJ, Oehninger S. Minimal ovarian hyperstimulation for in vitro fertilisation using sequential clomiphene citrate and gonadotropin with or without the addition of gonadotropinreleasing hormone antagonist. Fert Steril 2002; 78: 1068–72.
Vlaisavljević V, Reljič M, Gavrić Lovrec V, Kovačič B. Comparable effectiveness using flexible single-dose GnRH antagonist (cetrorelix) and singledose long GnRH agonist (goserelin) protokol for in-vitro fertilisation cycles – peospective, randomized study. Reprod Biomed Online 2003 – v tisku.
Mansour R, Aboulghar M, Serour GI, Al-Inany HG, Fahmy I, Amin Y. The use of clomiphene citrate/human menopausal gonadotrophins in conjunction with GnRH antagonists in an IVF/ICSI program is not a cost effective protocol. Acta Obstst Gynecol Scand 2003; 82: 48–52.
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