Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial

Fertility and Sterility
E M KolibianakisBasil Tarlatzis

Abstract

To evaluate whether the incidence of luteinizing hormone (LH) rise is reduced by using a flexible compared with a fixed day-6 protocol of GnRH antagonist administration. Randomized controlled trial. Tertiary university hospital. Patients undergoing in vitro fertilization (n = 146). Ovarian stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist cetrorelix (0.25 mg/d) was started either on day 6 of stimulation (fixed group) or when LH was >10 IU/L, and/or a follicle with mean diameter >12 mm was present, and/or serum E(2) was >150 pg/mL. Patient monitoring was initiated on day 3 of stimulation. Incidence of LH rise. No statistically significant difference was observed between the flexible and fixed groups regarding the incidence of LH rise, which was lower in the flexible group (11.0% vs. 15.1%, difference -4.1%, 95% confidence interval -15.4% to +7.1%). No LH surges were observed in any of the patients studied. Flexible antagonist administration from day 3 onward does not appear to reduce the incidence of LH rises compared with fixed antagonist administration on day 6 of stimulation.

References

Feb 13, 2001·Fertility and Sterility·M FlukerUNKNOWN North American Ganirelix Study Group
Mar 10, 2004·Human Reproduction Update·P Devroey, A Van Steirteghem
Jul 2, 2004·Human Reproduction·M H Mochtar, UNKNOWN Dutch Ganirelix Study Group
Nov 19, 2004·Acta Obstetricia Et Gynecologica Scandinavica·Efstratios KolibianakisPaul Devroey
Jun 14, 2005·Reproductive Biomedicine Online·Hesham Al-InanyGamal I Serour
Jun 23, 2005·Reproductive Biomedicine Online·Efstratios M KolibianakisPaul Devroey

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Citations

Mar 19, 2013·Reproductive Biology and Endocrinology : RB&E·Alan B Copperman, Claudio Benadiva
Mar 16, 2018·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Yudi GengLei Jin
Apr 18, 2018·Current Opinion in Obstetrics & Gynecology·Biljana Popovic-TodorovicChristophe Blockeel
Dec 13, 2019·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·Duoduo ZhangJingran Zhen
May 16, 2017·Journal of the Chinese Medical Association : JCMA·Li-Te LinKuan-Hao Tsui

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