The role of GnRH antagonists in assisted reproduction.
The different schemes of application of gonadotrophin-releasing hormone (GnRH) antagonists in ovarian stimulation protocols for assisted reproduction are reviewed. Starting from the initial schemes of single and/or multiple doses, the efficacy of GnRH antagonists in 'soft' protocols of ovarian stimulation has been evaluated in natural cycles, and the possibility of inducing the final oocyte maturation under antagonists either with native luteinizing hormone-releasing hormone or with GnRH agonists. The largest clinical studies carried out with cetrorelix or with ganirelix and published to date were analysed. Apart from the benefits of reducing the duration of the treatment, gonadotrophin requirements and ovarian hyperstimulation syndrome incidence, there is still a serious debate on the potential deleterious effect of GnRH antagonists on implantation and pregnancy rates. More specific aspects such as cycle programming, application of GnRH antagonists in protocols for poor responders etc., were also reviewed in this survey.
Barri
Pedro N
PN
Service of Reproductive Medicine, Department of Obstetrics and Gynecology, Institut Universitari Dexeus, Paseo Bonanova 67, 08017 Barcelona, Spain. perbar@iudexeus.uab.es
Martinez
Francisca
F
Coroleu
Buenaventura
B
Tur
Rosa
R
D002064:Buserelin / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted
D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; C061018:ganirelix; C062876:cetrorelix; D002064:Buserelin