The use of gonadotropin-releasing hormone antagonist post-ovulation trigger in ovarian hyperstimulation syndrome

Chappell, Neil; Gibbons, William E.

doi:10.5653/cerm.2017.44.2.57

Cited by 5 publications

(6 citation statements)

References 33 publications

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“…PCOS is a heterogeneous, multifactorial, complex endocrine disorder. Ovarian stimulation in assisted reproductive technology is widely used for the treatment of infertility in patients with PCOS since last 20 years (Chappell & Gibbons, ). Although both GnRH agonist and antagonist are used for ovarian stimulation, presently available studies give conflicting nature of findings.…”

Section: Discussionmentioning

confidence: 99%

“…Ovarian stimulation in assisted reproductive technology is widely used for the treatment of infertility in patients with PCOS since last 20 years (Chappell & Gibbons, 2017 PCOS is closely associated with obesity because of its original description by Stein & Leventhal, (1935). Approximately 50% of patients with PCOS are overweight or obese (Lim, Davies, Norman, & Moran, 2012).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of ovarian and metabolic effects of GnRH modulators in two rat models of polycystic ovary syndrome

Patel¹,

Shah

2018

Molecular Reproduction Devel

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Gonadotropin-releasing hormone (GnRH) modulators are widely used in numerous reproductive conditions including infertility. Several clinical studies showed mixed results regarding the efficacy of GnRH modulators in patients with polycystic ovary syndrome (PCOS). Along with this, few preclinical studies focus on the effect of GnRH modulators in PCOS-induced animals. Therefore, the present study was designed to study the effect of leuprolide and cetrorelix on hormonal, metabolic, and menstrual dysfunction PCOS rats. Prepubertal female rats were divided into four groups: Group I received a normal pellet diet and Groups II, III, and IV received 40% high-fat diet for 105 days. Similarly, adult female rats were divided into four groups: Group I received 1% carboxymethylcellulose (CMC) and Groups II, III, and IV received letrozole (1 mg/kg, per oral [p.o.] in 1% CMC) for 21 days. Thereafter, leuprolide (2.5 µg/rat, s.c.) and cetrorelix (10 µg/kg, subcutaneous [s.c.]) treatment were given to Group III and Group IV animals, respectively, for 21 days. Oral glucose tolerance test, lipid profile, fasting glucose, insulin, estrus cycle, hormonal profile, ovary weight, ovarian histopathological changes, and LHR and FSHR expressions were measured. Treatment with leuprolide and cetrorelix did not improve glucose intolerance, insulin level, insulin sensitivity indices, sex hormone levels, lipid profile, and estrus cycle. Only testosterone level, total cholesterol level, and follicular development were improved. Therefore, it was concluded that both leuprolide and cetrorelix showed improvement in follicular development, which could be helpful for improving fertility in PCOS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of ovarian and metabolic effects of GnRH modulators in two rat models of polycystic ovary syndrome

Patel¹,

Shah

2018

Molecular Reproduction Devel

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“…Several ovulation induction drugs exist, the most common of which are human menopausal gonadotropin (HMG) and clomiphene citrate [10,11]. Ovarian hyperstimulation and multiple births are the most important side effects of these medications [12][13][14]. The use of newer methods and a more comprehensive understanding of patients' genetic background can play an important role in reducing the side effects of these drugs.…”

Section: Introductionmentioning

confidence: 99%

“…Follicle-stimulating hormone (FSH) [15] and luteinizing hormone (LH) [16] are the hormones most crucially involved in the regulation and initiation of ovulation [13,17]. In women, the reduced secretion of LH or FSH interferes with the reproductive cycle.…”

Section: Introductionmentioning

confidence: 99%

Association of GRIA1 polymorphisms with ovarian response to human menopausal gonadotropin in Iranian women

Golestanpour

Javadi

Sheikhha

2020

Clin Exp Reprod Med

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Objective: Glutamate ionotropic receptor AMPA type subunit 1 (GRIA1) is a subunit of a ligand-gated ion channel that regulates the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) by controlling the release of gonadotropin-releasing hormone. Few studies have investigated the association between the GRIA1 gene and human infertility. This study evaluated the association of the GRIA1 rs548294 C > T and rs2195450 G > A polymorphisms with the ovarian response to human menopausal gonadotropin (HMG) in Iranian women.Methods: One hundred women with histories of at least 1 year of infertility were included. On the second day of menstruation, patients were injected with HMG; on the third day, blood samples were collected. After hormonal analysis, the GRIA1 rs548294 C > T and rs2195450 G > A genotypes of samples were identified via the restriction fragment length polymorphism method, and on day 9, the number of follicles was assessed via ultrasound.Results: For the GRIA1 rs548294 C > T and rs2195450 G > A single nucleotide polymorphisms, the subjects with CT and GG genotypes, respectively, displayed the highest mean FSH level, LH level, and number of follicles on day 9 of the menstrual cycle (p< 0.05). Significant positive correlations were observed between LH and FSH (p< 0.01), LH and follicle count (p< 0.01), FSH and age (p< 0.05), follicle count and age (p= 0.048), and FSH and follicle count (p< 0.01).Conclusion: This study showed a significant relationship between GRIA1 polymorphisms and ovarian response to the induction of ovulation. Therefore, determining patients’ GRIA1 genotype may be useful for improving treatment and prescribing suitable doses of ovulation-stimulating drugs.

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“…OHSS is a serious complication of IVF, and the treatment is expensive, which directly affects the total cycle costs. Studies have shown that the incidence of OHSS in the GnRH-antagonist protocol is lower than that in the GnRH-agonist long-protocol 18,23,24 . Accordingly, the cost of treating OHSS in the GnRH-antagonist protocol is lower, resulting in reduction in the total cycle cost.…”

mentioning

confidence: 99%

Cost-effectiveness analysis of GnRH-agonist long-protocol and GnRH-antagonist protocol for in vitro fertilization

Jing

Lin

Zhu

et al. 2020

Sci Rep

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The gonadotropin releasing hormone agonist (GnRH-a) long-protocols and the GnRH-antagonist protocols are two commonly used protocols for in vitro fertilization (IVF), but their cost-effectiveness has not been studied, especially in China. A retrospective study involving 1638 individuals in GnRH-a long-protocol and 621 in GnRH-antagonist protocol were conducted and a decision tree model analysis was used to analyze the cost-effectiveness. Both direct and indirect costs were calculated. As a result, during the fresh embryo transplantation cycles, there was no significant difference in the rate of ongoing pregnancy between the two protocols, the average cost of per ongoing pregnancy in the GnRH-antagonist protocol was $ 16970.85, and that in the GnRH-agonist long-protocol was $19902.24. The probability of cumulative ongoing pregnancy per start cycle was estimated at 60.65% for the GnRH-antagonist protocol and 71.6% for the GnRH-agonist long-protocol (P < 0.01). Considering the cumulative ongoing pregnancy rate, the mean costs per ongoing pregnancy were estimated at $8176.76 and at $7595.28 with GnRH-antagonist protocol and GnRH-agonist long protocol, respectively. In conclusion, in fresh embryo transplantation cycle, the GnRH-antagonist protocol has economic advantage. However, the GnRH-agonist long protocol is more cost effective considering the cumulative ongoing pregnancy rate in the fresh embryo and frozen embryo transplantation cycles. According to a World Health Organization (WHO) report, about 48.5 million couples are affected by infertility worldwide in 2010 1. With the refinement and development of assisted reproductive technology (ART), increasing number of infertile couples seek ART. The European Society of Human Reproduction and Embryology (ESHRE) reported that the worldwide number of babies born as a result of ART has reached an estimated total of 8 million since the world's first, Louise Brown, was born in July 1978 2. Up to now, ART is the most important method to treat infertility in the world. Study has shown that cumulative live birth rates are increased with the number of oocytes obtained 3. Therefore, controlled ovarian hyperstimulation (COH) is an important process to obtain a set number of oocytes for IVF. The GnRH-agonists were introduced into IVF in the late 1980s and the GnRH-agonist long-protocol is still the most frequently used protocol in most centers worldwide 4. The basic principle is to use gonadotropin-releasing hormone agonist (GnRH-a) to regulate pituitary and stimulate follicular growth with exogenous gonadotropin hormone, and avoid endogenous luteinizing hormone (LH) surge before oocyte retrieval 5,6. Since 1990s, GnRH antagonists were used in COH, this protocol competitively blocks pituitary GnRH receptors, inducing a rapid, reversible suppression of gonadotrophin secretion and preventing and interrupting LH surges 6-8. The GnRH-antagonist protocol have been widely adopted in IVF due to these advantages.

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The use of gonadotropin-releasing hormone antagonist post-ovulation trigger in ovarian hyperstimulation syndrome

Cited by 5 publications

References 33 publications

Evaluation of ovarian and metabolic effects of GnRH modulators in two rat models of polycystic ovary syndrome

Evaluation of ovarian and metabolic effects of GnRH modulators in two rat models of polycystic ovary syndrome

Association of GRIA1 polymorphisms with ovarian response to human menopausal gonadotropin in Iranian women

Cost-effectiveness analysis of GnRH-agonist long-protocol and GnRH-antagonist protocol for in vitro fertilization

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