Evaluation of pretreatment with Cetrotide in an antagonist protocol for patients
            with PCOS undergoing IVF/ICSI cycles: a randomized clinical trial

Eftekhar, Maryam; Bagheri, Ramesh Baradaran; Neghab, Nosrat; Hosseinisadat, Robabe

doi:10.5935/1518-0557.20180039

Cited by 6 publications

(5 citation statements)

References 27 publications

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“…As a result of this treatment, multiple mature oocytes can be retrieved, fertilized in vitro, and implanted, increasing the chances of a live birth. In particular, and similar to our case, patients undergoing fertility stimulation therapy usually receive follitropin alfa, HCG, leuprolide (injectable treatment), and cetrotide (11)(12)(13)(14). Follitropin alfa, or follicle-stimulating hormone (FSH), is a hormone promoting the development and maturation of oocytes in the ovaries (11).…”

Section: Introductionmentioning

confidence: 61%

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Controlled ovarian stimulation therapy as a potential risk for the development and progression of renal cell carcinomas: A case report and literature review

et al. 2021

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Renal Cell Carcinoma (RCC) is the most common type of cancer in the kidney and is mostly asymptomatic. Previous studies have supported the important role of sex hormones in RCC pathophysiology and that targeted hormone receptor therapy, such as estrogen receptor targeting, is a promising treatment strategy. However, to the best of our knowledge, it remains unknown whether hormonal therapy, such as controlled ovarian stimulation for in vitro fertilization, serves a role in the development and progression of RCC. The present report describes a case of RCC developed after a fertility stimulation therapy and provides a summary of the known literature on the role of hormone receptors in the development and progression of RCC. A 35-year-old woman received fertility stimulation treatment with follitropin alfa 900 units, human chorionic gonadotropic hormone 5,000 units, injectable leuprolide 1 mg/0.2 ml and cetrotide 0.25 mg. The patient presented to the hospital with shortness of breath and weight loss. The patient had no known genetic predisposition or family history of malignancies and no exposure to chemicals. The patient never used tobacco, alcohol or recreational drugs. Imaging revealed a 17x19 mm, heterogeneously enhancing, and partially exophytic mass in the right kidney. After partial nephrectomy, the pathological evaluation confirmed the diagnosis of clear cell RCC. To the best of our knowledge, this was the first time that a case of ovarian stimulation therapy was associated with the development of RCC. This case raises concerns about the potential oncogenic effect of controlled ovarian stimulation therapy in RCC promotion, suggesting a need for systematic research to clarify the clinical significance of existing pre-clinical data.

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Section: Introductionmentioning

confidence: 61%

“…Leuprolide is a synthetic gonadotropin-releasing hormone (GnRH) (13). Cetrotide is used to block the hormone GnRH to be released from the ovaries, regulating hormone responses in women during fertility treatments (14). Direct morbidity and mortality related to IVF are relatively low.…”

Section: Introductionmentioning

confidence: 99%

Controlled ovarian stimulation therapy as a potential risk for the development and progression of renal cell carcinomas: A case report and literature review

et al. 2021

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“…A meta-analysis of the delayed initiation of antagonist pretreatment for low-response patients showed that this measure reduces the Gn dose and increases the clinical pregnancy rate. Studies have also found that pretreatment with antagonists in PCOS patients can increase the biochemical pregnancy rate and significantly reduce the incidence of OHSS [ 27 ]. Patients with PCOS and poor responders were excluded from the study The influence of different ovarian reactions on the results can be excluded, thus making the research data more reliable.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of GnRH antagonist pretreatment before ovarian stimulation in a GnRH antagonist protocol in normal ovulatory women undergoing IVF/ICSI: a randomized controlled trial

Zhang

Liu

Qin

et al. 2021

Reprod Biol Endocrinol

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Background Synchronization of follicles is key to improving ovulation stimulation with the gonadotropin-releasing hormone (GnRH) antagonist protocol. GnRH antagonist administration in the early follicular phase can quickly decrease gonadotrophin (Gn) levels and achieve downregulation before stimulation, which may improves synchronization. A previous small randomized controlled study (RCT) showed that pretreatment with a GnRH antagonist for 3 days before stimulation may increase oocyte retrieval but cannot increase the pregnancy rate. This study investigated whether the GnRH antagonist pretreatment protocol in ovulatory women can increase the synchronization of follicles and pregnancy outcomes compared with the conventional GnRH antagonist protocol. Methods This RCT included 136 normal ovulatory women undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Both groups were treated with recombinant follicle-stimulating hormone (r-FSH) and a flexible GnRH antagonist protocol. The women were randomized into two equal groups with or without GnRH antagonist administration from day 2 of the menstrual cycle for 3 days before stimulation. Our primary outcome was the number of retrieved oocytes. Secondary outcomes included the pregnancy rate and live birth rate. Results Both groups had similar baseline characteristics. The number of retrieved oocytes in the study group was comparable to that in the control group (9.5 [8.0–13.0] vs. 11.0 [7.0–14.8], P = 0.469). There was no significant difference in the follicle size. The fertilization rate, number of good-quality embryos, implantation rate, pregnancy rate, ongoing pregnancy rate, live birth rate per embryonic transfer cycle, and miscarriage rate were similar between the two groups. Conclusion This large RCT analysed GnRH antagonist pretreatment with the GnRH antagonist protocol applied to normal ovulatory women undergoing IVF/ICSI. The number of retrieved oocytes and pregnancy outcomes did not significantly vary. Trial registration Chinese Clinical Trial Registry, ChiCTR1800019730. Registered 26 November 2018.

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“…A meta-analysis of the delayed initiation of antagonist pre-treatment for low-response patients showed that this measure reduces the Gn dose and increases the clinical pregnancy rate. Studies have also found that pre-treatment with antagonists for PCOS patients can increase the biochemical pregnancy rate and signi cantly reduce the incidence of OHSS [27]. PCOS and poor responders were excluded from the patients enrolled in this study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of GnRH antagonist pre-treatment before ovarian stimulation in a delayed-start antagonist protocol in normal ovulatory women undergoing IVF/ICSI: a randomized controlled trial (RCT)

Zhang

Liu

Qin

et al. 2021

Preprint

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Background: Synchronization of follicles is key to improving ovulation stimulation with the GnRH antagonist protocol. GnRH antagonist administration in the early follicular phase can quickly decrease gonadotrophin (Gn) levels and achieve downregulation before stimulation, which improves synchronization. A small RCT showed that pre-treatment with a GnRH antagonist for three days before stimulation might increase oocyte retrieval but cannot increase the pregnancy rate. This study investigated whether the "delayed-start" protocol in ovulatory women can increase the synchronization of follicles and pregnancy outcomes compared with the conventional GnRH antagonist protocol.Methods: This RCT included 136 normal ovulatory women undergoing IVF/ICSI. Both groups were treated with recombinant FSH (r-FSH) and a flexible GnRH antagonist protocol. The women were randomized into two equal groups with or without GnRH antagonist from day 2 of the menstrual cycle. Our primary outcome was the number of oocytes retrieved. Secondary outcomes included the pregnancy and live birth rates.Results: Both groups had similar baseline characteristics. The number of oocytes retrieved in the study group was comparable to that in the control group (9.5(8.0-13.0) vs. 11.0(7.0-14.8),P=0.469). There was no statistical significance among the follicular size differences. The fertilization rate, number of good-quality embryos, implantation rate, pregnancy rate, ongoing pregnancy rate, live birth rate per ET cycle, and miscarriage rate were all similar between the two groups.Conclusion: This large RCT analysed the "delayed-start" GnRH antagonist protocol applied to normal ovulatory women performing IVF/ICSI. The number of oocytes retrieved and pregnancy outcomes did not vary significantly. Future trials need to confirm these findings.Trial registration: Chinese Clinical Trial Registry, ChiCTR1800019730. Registered 26 November 2018,http://www.chictr.org.cn/showproj.aspx?proj=29969.

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Evaluation of pretreatment with Cetrotide in an antagonist protocol for patients with PCOS undergoing IVF/ICSI cycles: a randomized clinical trial

Cited by 6 publications

References 27 publications

Controlled ovarian stimulation therapy as a potential risk for the development and progression of renal cell carcinomas: A case report and literature review

Controlled ovarian stimulation therapy as a potential risk for the development and progression of renal cell carcinomas: A case report and literature review

Evaluation of GnRH antagonist pretreatment before ovarian stimulation in a GnRH antagonist protocol in normal ovulatory women undergoing IVF/ICSI: a randomized controlled trial

Evaluation of GnRH antagonist pre-treatment before ovarian stimulation in a delayed-start antagonist protocol in normal ovulatory women undergoing IVF/ICSI: a randomized controlled trial (RCT)

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