Preliminary report on the effect of a lower dose of gonadotropin-releasing hormone antagonist (cetrorelix) on ovarian hyperstimulation in lower-weight Asian women.
OBJECTIVE
To determine the minimal effective daily dose of gonadotropin-releasing hormone (GnRH) antagonist in lower-weight Asian women undergoing controlled ovarian hyperstimulation (COH).


METHODS
A prospective randomized controlled trial of GnRH antagonist was performed. A total of 58 women with body weight of 40-50 kg accepted COH and transvaginal embryo transfer. Patients were divided into two groups: Group 1 patients (n = 28) were given a fixed cetrorelix dose of 0.2 mg/day; Group 2 patients (n = 30) were given a fixed cetrorelix dose of 0.15 mg/day. Cetrorelix was administered from menstrual day 8 until the day of human chorionic gonadotropin (hCG) administration. Serum luteinizing hormone (LH) and estradiol (E2) concentration were measured on the day of hCG administration. Gonadotropin dosages, LH and E2 concentrations, retrieved oocyte and embryo numbers, ovarian hyperstimulation syndrome (OHSS), embryo quality, and the rates of fertilization, implantation and pregnancy in both groups were compared.


RESULTS
The clinical pregnancy/implantation rates in Group 1 were higher than those in Group 2 (28.6%/10.4% vs. 20%/4.1%). The numbers of oocytes retrieved/Grade I-II embryos were higher in Group 1 than Group 2 (10.5/7.8 vs. 8.3/3.9). A lower percentage of LH surge and higher E2 levels on the day of hCG administration were observed in Group 1 compared to Group 2 (5.9%/1,610.8 pg/mL vs. 26.7%/1,023.6 pg/mL). There were no statistical differences between the two groups when comparing gonadotropin dosage and OHSS.


CONCLUSIONS
The lowest effective dosage of cetrorelix is 0.2 mg in COH and pituitary downregulation for lower-weight Asian women.
Chang
Yung-Ling
YL
Department of Obstetrics and Gynecology, Tung's Metro Harbor Hospital, Taichung, Taiwan.
Hsieh
Yao-Yuan
YY
Tsai
Horng-Der
HD
D000328:Adult; D044466:Asian People; D001835:Body Weight; D010064:Embryo Implantation; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage; 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; D010060:Ovulation / Q000187:drug effects*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
D043373:Follicle Stimulating Hormone, Human; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone; C062876:cetrorelix