A randomised study of GnRH antagonist (cetrorelix) versus agonist (busereline) for controlled ovarian stimulation: effect on safety and efficacy

Xavier, Pedro; Gamboa, Cristina; Calejo, Lucinda; Silva, Joaquina; Stevenson, D.K.; Nunes, A. L. L.; Martinez-de-Oliveira, José

doi:10.1016/j.ejogrb.2004.11.005

Cited by 40 publications

(29 citation statements)

References 10 publications

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“…As already established in the literature, both protocols are similar (Loutradis et al, 2004;Prapas et al, 2005;Xavier et al, 2005;Aletebi, 2007;Kurzawa et al, 2008;Hosseini et al, 2010;Tehraninejad et al, 2010;Al-Inany et al, 2011;Bodri et al, 2011;Gilliam, 2011;Pu et al, 2011;Haydardedeoglu et al, 2012;Pundir et al, 2012). We found the same results in our study.…”

Section: Discussionsupporting

confidence: 82%

“…We found the same results in our study. As demonstrated in this study, there is no difference in oocytes retrieval between these two protocols in recent meta analysis (Tehraninejad et al, 2010;Bodri et al, 2011;Pu et al, 2011;Casano et al, 2012;Pundir et al, 2012) and randomized controlled trials (Loutradis et al, 2004;Xavier et al, 2005;Kurzawa et al, 2008;Tazegul et al, 2008). Differently, some reports showed a less number of oocyte retrieval in the antagonist protocol (Barmat et al, 2005;Arruda et al, 2013;Orvieto & Patrizio, 2013).…”

Section: Discussionmentioning

confidence: 75%

“…The idea of impossibility of mobility was not a compliance of our group and should be discussed the possibility of use of more antagonist in case of discomfort of schedule but implicate in a more costs in protocol. It is expected that the availability of evidence-based information on the optimal use of GnRH antagonists will enhance the probability of pregnancy associated with their application in ovarian stimulation (Xavier et al, 2005). In addition to the flexible antagonist protocol be safer in terms of less likelihood of OHSS and the patient could not be pregnant at the beginning of the cycle (Al-Inany et al, 2011;Depalo et al, 2012), we also consider that the fact of the shorter duration of the stimulus and the least amount of FSH units required are economic factors that also influence the therapeutic decision of the human reproduction team.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ovarian stimulation with GnRH analogues

Montenegro¹,

Faller²,

Almeida³

et al. 2014

JBRA Assisted Reproduction

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Objective: Analysis and compare data between two induction protocols (long agonist and flexible antagonist) in patients submitted an assisted reproduction technique in Porto Alegre. Methods: Cross-sectional study comparing the intermediate results with the use of two different ovarian stimulation protocols with gonadotropin-releasing hormone agonist versus antagonist to assisted reproductive techniques. The statistical analysis of the retrieved data (age, body mass index, number of oocytes recovered, number of fertilized oocytes, number of oocytes cleaved, total dose of FSH used and ovarian hyperstimulation syndrome) was performed by Student's t-test for parametric data and analysis of covariance for the dependent variables. Results: A total of 50 patients, 25 in each group, met the criteria for inclusion in the study between January and March in the year 2010. There was statistically significant difference only in the middle ages between the groups (P = 0.031). There was no statistical difference for the remaining data analyzed (body mass index, number of oocytes recovered, number of fertilized oocytes, number of oocytes cleaved and dose of FSH utilized). There were no cases of ovarian hyperstimulation syndrome. Conclusion: Both protocols are equal in terms of results. The agonist has advantages about scheduling of the procedure, but it takes too long to start the stimulation and have possibility to start medication in a pregnant patient. Added to this, we have the possibility of getting the ovarian hyperstimulation syndrome as complication. In the antagonist group, is clear the ease-of-use of the medication and the fastest start of stimulation.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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Ovarian stimulation with GnRH analogues

Montenegro¹,

Faller²,

Almeida³

et al. 2014

JBRA Assisted Reproduction

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“…GnRHantagonists have been shown to inhibit the synthesis of growth factors, to induce apoptosis, and also to decrease an already compromised uterine receptivity during ovarian stimulation with gonadotropins [11,12]. However, in a randomized study comparing the outcomes of ovarian stimulation with pituitary down-regulation with GnRHagonists versus GnRH-antagonist, Xavier et al found comparable endometrial thickness on the day of hCG administration (and comparable serum estradiol levels), and pregnancy outcomes [13]. In our study, as well, we were not able to find the use of GnRH-antagonist a predictor of implantation failure.…”

Section: Discussionmentioning

confidence: 99%

Timing and duration of use of GnRH antagonist down-regulation for IVF/ICSI cycles have no impact on oocyte quality or pregnancy outcomes

Detti

Ambler

Yelian

et al. 2008

J Assist Reprod Genet

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Purpose To evaluate whether oocyte quality, implantation and pregnancy outcomes in in vitro fertilization (IVF)/ intra-cytoplasmic sperm injection (ICSI) are related to the duration of gonadotropin-releasing hormone (GnRH)-antagonist use or the timing of its initiation. Methods Retrospective cohort study of 178 conventional IVF/ICSI cycles. All patients underwent ovarian stimulation with gonadotropins and GnRH-antagonist for pituitary down-regulation. Spearman correlations and logistic regression were used for statistical analysis. Results There was no correlation between the duration of use or the timing of initiation of GnRH-antagonist with oocyte quality or implantation and pregnancy outcomes. Oocyte quality was influenced by the peak estradiol. Implantation was influenced by the patient's age. Early pregnancy loss, by the endometrial thickness on human chorionic gonadotropin-day. Ongoing pregnancy was independent from the variables evaluated.Conclusions GnRH-antagonist duration of use or starting day did not influence oocyte quality, implantation rates, and pregnancy rates. We hypothesize that a follicle stimulating hormone/luteinizing hormone dose increase when antagonist was started, may have had an impact on our findings.

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“…This experience is also in line with the results from randomized clinical trials, which have shown that the short protocol with a GnRH antagonist is the first choice in IVF programmes, with fewer complications, reduced risk of OHSS and sufficient success. [17,21] In all types of stimulation protocols, ovarian stimulation is performed with gonadotropins (FSH products: urinary, recombinant or a combination of both). In recent years, many studies and debates have been conducted on the effectiveness of rFSH compared to urFSH.…”

Section: Comparative Analysismentioning

confidence: 99%

Cost-effectiveness of short COH protocols with GnRH antagonists using different types of gonadotropins for in vitro fertilization

Petrova

Benbassat²,

Lakic

et al. 2016

Biotechnology & Biotechnological Equipment

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The aim of this study was to explore the cost-effectiveness of short protocols including different types of gonadotropins for controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF). A retrospective, observational study of the real-life practice in a specialized IVF gynaecology clinic in 2009À2013 was carried out. All women on short COH protocols were recruited into three groups: COH including recombinant follicle stimulating hormone (rFSH) and urinary-FSH (urFSH) (n D 173); including urFSH alone (n D 289); and including rFSH alone (n D 212). The costeffectiveness of the COH protocols was explored in two different case scenarios for possible outcomes. The first case scenario took into consideration a successful live birth, and the second one, the women to achieve pregnancy with live birth. Decision modelling was done using the TreeAge 2014 Software. According to the results in the first case scenario, the rFSH plus urFSH COH approach showed the highest weighted probability (p D 0.38) of live birth, but the urFSH alternative was cost-effective. The results in the second case scenario demonstrated that the urFSH protocol was again the cost-effective alternative. These results suggest that the strategy with urFSH should be preferred in both cases, but rFSH could also be considered as a cost-effective alternative for successful live birth and achieving pregnancy and delivery, since the incremental costeffectiveness ratio in comparison with the urFSH protocol is below the gross domestic product per capita. The combined approach of rFSH and urFSH was shown not to be cost-effective in both explored scenarios.

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A randomised study of GnRH antagonist (cetrorelix) versus agonist (busereline) for controlled ovarian stimulation: effect on safety and efficacy

Cited by 40 publications

References 10 publications

Ovarian stimulation with GnRH analogues

Ovarian stimulation with GnRH analogues

Timing and duration of use of GnRH antagonist down-regulation for IVF/ICSI cycles have no impact on oocyte quality or pregnancy outcomes

Cost-effectiveness of short COH protocols with GnRH antagonists using different types of gonadotropins for in vitro fertilization

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