Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin).
OBJECTIVE
To confirm the value of a single dose of 3 mg of cetrorelix in preventing the occurrence of premature LH surges.


METHODS
Multicenter randomized, prospective study.


METHODS
Reproductive medicine units.


METHODS
Infertile patients undergoing ovarian stimulation for IVF-ET.


METHODS
A single dose of 3 mg of cetrorelix (Cetrotide; ASTA Medica, Frankfurt, Germany) (115 patients) was administered in the late follicular phase. A depot preparation of triptorelin (Decapeptyl; Ipsen-Biotech, Paris, France) was chosen as a control agent (39 patients). Ovarian stimulation was conducted with hMG (Menogon; Ferring, Kiel, Germany).


METHODS
Premature LH surges (LH level >10 IU/L), progesterone level greater than 1 ng/L, and IVF results.


RESULTS
No LH surge occurred after cetrorelix administration. The patients in the cetrorelix group had a lower number of oocytes and embryos. The percentage of mature oocytes and fertilization rates were similar in both groups, and the pregnancy rates were not statistically different. The length of stimulation, number of hMG ampules administered, and occurrence of the ovarian hyperstimulation syndrome were lower in the cetrorelix group. Tolerance of cetrorelix was excellent.


CONCLUSIONS
A cetrorelix single-dose protocol prevented LH surges in all patients studied. It compares favorably to the "long protocol" and could be a protocol of choice in IVF-ET.
Olivennes
F
F
Department of Obstetrics and Gynecology, A. Béclère Hospital, Clamart, France.
Belaisch-Allart
J
J
Emperaire
J C
JC
Dechaud
H
H
Alvarez
S
S
Moreau
L
L
Nicollet
B
B
Zorn
J R
JR
Bouchard
P
P
Frydman
R
R
D000328:Adult; D003692:Delayed-Action Preparations; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood* / Q000187:drug effects; D008186:Luteolytic Agents / Q000008:administration & dosage*; D018587:Oocyte Donation; D009865:Oocytes / Q000502:physiology; D010060:Ovulation / Q000187:drug effects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000008:administration & dosage*
D003692:Delayed-Action Preparations; D006727:Hormone Antagonists; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; C062876:cetrorelix