Effect of a lower-dose cetrorelix acetate protocol on in-vitro fertilization outcome.
OBJECTIVE
To determine whether a low initial dosage of cetrorelix acetate could prevent a premature luteinizing hormone (LH) surge in women undergoing controlled ovarian stimulation.


METHODS
Treatment with a recombinant follicle stimulating hormone was started on Day 3 of the menstrual cycle, and 0.125 mg of cetrorelix was injected daily from Day 5 of the ovarian stimulation until the diameter of the dominant follicle reached at least 16 mm. The dosage was then doubled and maintained at 0.250 mg/day until the day before the injection of human chorionic gonadotropin.


RESULTS
There was a significant decrease in serum LH concentration 1 day after doubling the cetrorelix dosage, and the LH concentration remained low during the follicular phase. Clinical pregnancy occurred in 18 women (42.8%), with 2 intrauterine fetal deaths before the 12th week.


CONCLUSIONS
Increasing the cetrorelix dosage from 0.125 to 0.250 mg/day when the follicular size is appropriate can prevent a premature LH surge.
Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan.
Chii-Ruey
CR
Tzeng
Heng-Ju
HJ
Chen
Yu-Hung
YH
Lin
Bih-Chwen
BC
Hsieh
Lee-Wen
LW
Huang
Jiann-Loung
JL
Hwang
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D007986:Luteinizing Hormone / Q000097:blood*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D016896:Treatment Outcome
D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; C062876:cetrorelix