Ovarian stimulation by clomiphene citrate and hMG in combination with cetrorelix acetate for ICSI cycles.
BACKGROUND
The introduction of GnRH antagonists such as cetrorelix acetate has made possible the simplification of ovarian stimulation. However, the most effective protocol for their administration has not yet been clearly defined.


METHODS
Forty women with male-factor infertility undergoing 40 ICSI cycles were included in the study. Clomiphene citrate at 100 mg a day was given from cycle day 3 through day 7. hMG at 150 IU was given on cycle days 4, 6 and 8, and was adjusted from day 9 according to the follicular and hormone responses. Cetrorelix acetate at 2.5 mg was administered when the leading follicle reached 14 mm. The remaining 0.5 mg was divided into two 0.25 mg injections for possible later use. Serum FSH, LH, estradiol and progesterone levels were measured daily from the day of cetrorelix acetate injection until hCG was given.


RESULTS
Serum LH level was suppressed effectively for 4 days. Four patients (10%) needed one or two additional injections of 0.25 mg cetrorelix acetate. No premature LH surge was detected in any of the women treated. Sixteen women became pregnant (40%), of which 14 pregnancies (35%) were ongoing at the time of writing.


CONCLUSIONS
This study demonstrates that this new protocol is feasible for couples with male-factor infertility undergoing ICSI.
Hwang
Jiann-Loung
JL
Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Huang
Lee-Wen
LW
Hsieh
Bih-Chwen
BC
Tsai
Yieh-Loong
YL
Huang
Shih-Chia
SC
Chen
Chin-Yu
CY
Hsieh
Mei-Ling
ML
Chen
Pei-Hsin
PH
Lin
Yu-Hung
YH
D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D007248:Infertility, Male; D007986:Luteinizing Hormone / Q000037:antagonists & inhibitors; D008297:Male; D008596:Menotropins / Q000008:administration & dosage / Q000627:therapeutic use*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic
D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D007986:Luteinizing Hormone; C062876:cetrorelix