The impact of a gonadotropin-releasing hormone antagonist on gonadotropin ovulation induction cycles in women with polycystic ovary syndrome: a prospective randomized study.
OBJECTIVE
To evaluate the effect of the gonadotropin-releasing hormone antagonist Ganirelix on gonadotropin ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS).


METHODS
Prospective, randomized, controlled study.


METHODS
Academic infertility center.


METHODS
Ninety-eight anovulatory women with PCOS undergoing 154 gonadotropin OI cycles.


METHODS
Patients were treated with recombinant FSH alone (group 1) or in conjunction with Ganirelix when the leading follicle was ≥13 mm (group 2) versus from the beginning of stimulation (group 3), followed by IUI.


METHODS
Per cycle clinical pregnancy rate (CPR), live-birth rate (LBR), total gonadotropin dose, days of stimulation, serum LH and peak E2, and premature luteinization rate.


RESULTS
Data are suggestive of improved CPR in group 2 versus group 1 (33% vs. 19%) and LBR (35% vs. 20%) but not significantly different. Premature luteinization was highest in group 1 (21% vs. 1.8% in group 2 and 2.1% in group 3). Group 3 had the highest cancellation rate and cost without improving CPR and LBR. No differences were noted in peak serum E2, total gonadotropin dose, or days of stimulation.


CONCLUSIONS
Adding Ganirelix in a flexible protocol to gonadotropin OI cycles in women with PCOS may be beneficial by decreasing premature luteinization.
Stadtmauer
Laurel A
LA
Jones Institute of Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA. stadtmLA@EVMS.edu
Sarhan
Abbaa
A
Duran
E Hakan
EH
Beydoun
Hind
H
Bocca
Silvina
S
Pultz
Beth
B
Oehninger
Sergio
S
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors*; D006062:Gonadotropins / Q000008:administration & dosage; D006727:Hormone Antagonists / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000503:physiopathology; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage
D006062:Gonadotropins; D006727:Hormone Antagonists; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; C061018:ganirelix