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Application of GnRH antagonist in combination with clomiphene citrate and hMG for patients with exaggerated ovarian response in previous IVF/ICSI cycles

  • Assisted Reproduction
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Abstract

Purpose

To investigate if the combination of clomiphene citrate, hMG, and cetrorelix (CC/hMG/cetrorelix protocol) can be applied to patients who had excessive response to GnRHa long protocol.

Methods

Fifty patients who coasted and failed to conceive in their first cycles stimulated with GnRHa long protocol were stimulated with CC/hMG/cetrorelix protocol. The peak serum estradiol levels, the need of coasting and prolonged coasting (≥4 days), and the incidences of OHSS were compared.

Results

The peak estradiol level was significantly lower with CC/hMG/cetrorelix protocol compared to GnRHa long protocol. With CC/hMG/cetrorelix protocol, only four patients (8%) needed coasting and no one coasted ≥4 days. In contrast, in the first cycles, 11 patients (22%) needed coasting ≥4 days. The incidence of moderate OHSS was significantly lower with CC/hMG/cetrorelix protocol.

Conclusions

The CC/hMG/cetrorelix protocol is an acceptable alternative protocol for patients who had excessive response to GnRHa long protocol.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95 Wen Chang Road, Shih Lin District, Taipei, 111, Taiwan

    Yu-Hung Lin, Kok-Min Seow, Bih-Chwen Hsieh, Lee-Wen Huang, Heng-Ju Chen, Shih-Chia Huang, Chih-Yu Chen, Pei-Hsin Chen & Jiann-Loung Hwang

  2. College of Medicine, Fu Jen Catholic University, Taipei, Taiwan

    Yu-Hung Lin, Bih-Chwen Hsieh, Lee-Wen Huang & Jiann-Loung Hwang

  3. Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan

    Yu-Hung Lin

  4. Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan

    Jiann-Loung Hwang & Chi-Ruey Tzeng

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  1. Yu-Hung Lin
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  2. Kok-Min Seow
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  3. Bih-Chwen Hsieh
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  4. Lee-Wen Huang
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  7. Chih-Yu Chen
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  8. Pei-Hsin Chen
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  9. Jiann-Loung Hwang
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Corresponding author

Correspondence to Jiann-Loung Hwang.

Additional information

Clomiphene citrate/hMG/cetrorelix protocol is a good alternative for patients who had excessive response to GnRHa long protocol.

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Lin, YH., Seow, KM., Hsieh, BC. et al. Application of GnRH antagonist in combination with clomiphene citrate and hMG for patients with exaggerated ovarian response in previous IVF/ICSI cycles. J Assist Reprod Genet 24, 331–336 (2007). https://doi.org/10.1007/s10815-007-9127-8

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  • DOI: https://doi.org/10.1007/s10815-007-9127-8

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