The role of LHRH agonists and antagonists

Chillik, Claudio F.; Acosta, Anı́bal A.

doi:10.1016/s1472-6483(10)62236-5

Cited by 32 publications

(16 citation statements)

References 24 publications

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“…This phenomenon has been attributed to downregulation of the GnRH receptors combined with disruption of the postreceptor signaling process (3)(4)(5). Gonadotropin-releasing hormone agonists have been used extensively in controlled ovarian hyperstimulation protocols for IVF to prevent premature luteinization.…”

Section: Discussionmentioning

confidence: 99%

Follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase

Vlahos

Choussein

Economopoulos

2009

Fertility and Sterility

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Section: Discussionmentioning

confidence: 99%

Follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase

Vlahos

Choussein

Economopoulos

2009

Fertility and Sterility

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“…After their binding to the receptors, they initially cause gonadotropin release (flare-up effect), and after several days of continuous administration they result in a dramatic drop of the circulating concentrations of FSH and LH through a desensitization mechanism. GnRH agonists have greater affinity for the GnRHR than native GnRH; they also have greater resistance to enzymatic breakdown and a prolonged half-life compared to native GnRH (i.e., native GnRH has a half-life of about 2-4 min compared to 3 h for GnRH agonist, leuprolide) [40]. The internalization of receptors and the slow dissociation of the agonist-receptor complex decrease the total number of functional GnRHRs, leading to a prolonged desensitization [41].…”

Section: Gnrh Agonistsmentioning

confidence: 99%

Gonadotropin-Releasing Hormone Agonists in Fertility Preservation

Çakmak

Seli

2011

Fertility Preservation

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Fertility preservation in females diagnosed with cancer has become an important area of investigation due to increasing cancer survival rates combined with delayed childbearing. Initial studies using gonadotropinreleasing hormone (GnRH) agonist cotreatment with chemotherapy demonstrated promising results for fertility preservation. If this protective effect of GnRH agonists is confirmed by the ongoing prospective randomized clinical trials, GnRH agonist cotreatment may become valuable option for fertility preservation in reproductive-age women undergoing chemotherapy. Thus, ovarian protection may enable the preservation of future fertility in survivors and, in addition, prevent other adverse effects of premature menopause, such as bone density loss, sexual dysfunction, and vasomotor symptoms. Keywords Gonadotropin-Releasing Hormone Agonists in Fertility PreservationHakan Cakmak and Emre Seli 13Cancer is not uncommon among younger women of reproductive age. More than 710,000 new female cancer cases were estimated to be diagnosed in 2009 in the USA [1]. Approximately 10% of female cancer cases occur under the age of 40 years [2]. Over the past three decades, there has been a remarkable improvement in the survival rates due to progress in cancer treatment. With improvements in treatment outcomes, 82% of women younger than 45 years diagnosed with cancer survived between 1999 and 2006 [2]. Moreover, it was previously estimated that by 2010, one in 250 adult women will be a cancer survivor [3]. As a consequence of the increase in the number of patients surviving cancer, greater attention has been focused on the effects of cancer treatment on the quality of life of the survivor.The treatment for most of the common cancer types in younger women involves either removal

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“…Currently, at least five antagonists are in clinical studies; however, they are mainly for assisted reproduction and cancer treatment (abarelix, antarelix cetrolelix, degarelix and ganirelix) [19][20][21][22][23][24][25][26][27]. Cetrorelix is the most studied antagonist so far.…”

Section: Gnrh Antagonistsmentioning

confidence: 99%

“…The GnRH antagonists seem to have some advantages in assisted reproduction with fewer adverse effects but have 497 somewhat lower pregnancy rates [21]. A randomised, controlled study [21,27] on controlled ovulation has compared cetrorelix with buserelin but no significant differences of importance were demonstrated.…”

Section: Gnrh Antagonistsmentioning

confidence: 99%

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Treatment of central precocious puberty

Tuvemo

2006

Expert Opinion on Investigational Drugs

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The problems of central precocious puberty (CPP) are serious enough to the patient to deserve treatment. There is a general consensus among paediatric endocrinologists that the treatment of true CPP (i.e., in children young enough to have a formal diagnosis) is indicated in many cases. In children with modestly early puberty who are not fulfilling the diagnostic criteria, this is not the case. The treatment of choice is a gonadotropin-releasing hormone (GnRH) analogue. Prolonged analogues are more effective than short-acting ones and, most importantly, independent of patient compliance. Data on agonists have accumulated over two decades and evidence of effects is rich in girls but sparse in boys. GnRH agonists are generally effective and safe drugs; the suppression of puberty is reversible and there is much information on GnRH agonists for the treatment of CPP showing very few adverse effects and the effects on final height are well documented in girls < 6 years of age. There is some (but not highly convincing) evidence for their effect on final height for those of 6 - 8 years of age and there is no evidence for an increase in final height after the age of 8 years in girls. If a decision to have treatment is taken, treatment should start immediately as a possible benefit is less probable if the start of treatment is delayed. When treatment should be stopped is a matter of controversy. Combination with growth hormone increases final height, but the clinical relevance can be discussed as well as the health economy aspects. The limits of indications are still to be defined.

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The role of LHRH agonists and antagonists

Cited by 32 publications

References 24 publications

Follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase

Follicular development, acquisition of mature oocytes, and pregnancy after 2 weeks of leuprolide acetate administration during the midluteal phase

Gonadotropin-Releasing Hormone Agonists in Fertility Preservation

Treatment of central precocious puberty

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