[Revisiting the clomifene-gonadotropin protocol in IVF with the use of a GnRH antagonist].
OBJECTIVE
To assess the ability of GnRH antagonists to prevent LH surges during superovulation for IVF in classical stimulation protocols with clomiphene and gonadotropins.


METHODS
Fifty-eight patients were treated with clomiphene (100 mg daily for 5 days starting on cycle day 2) and gonadotropins (225 UI HMG on cycle days 5, 7 and 9), with monitoring starting on cycle day 10. Cetrorelix, 0.25 mg, was administered daily when dominant follicle diameter reached 18 mm and/or plasma estradiol levels 800 pg/ml.


RESULTS
No premature LH surge was observed during the 48 stimulation cycles completed. The pregnancy rate was 20.8% per punction and 25.6% per transfer, and there was no clinical ovarian hyperstimulation syndrome in these series.


CONCLUSIONS
Cetrorelix, 0.25 mg, optimizes the classical stimulation with clomiphene and gonadotropins by preventing LH surges; the so-completed protocol yields acceptable pregnancy rates with lower hormone quantities and reduced risks of ovarian hyperstimulation, and becomes a convenient choice when "softer" treatments for IVF are considered.
Emperaire
J-C
JC
Centre de FIV Aquitaine-Santé, clinique Jean-Villar, 33520 Bruges, France. jc.emperaire@aquitanesante.fr
Parneix
I
I
Perraguin-Jayot
S
S
D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage*; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D013480:Superovulation / Q000187:drug effects / Q000378:metabolism; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; C062876:cetrorelix