Abstract
Purpose: The premature LH surge in ART programs seems to be avoided by daily administration of the GnRH-antagonist Cetrorelix during the midcycle phase in controlled ovarian hyperstimulation with hMG. The dosage necessary for sufficient suppression of the pituitary gland is not yet defined.
Methods: To elucidate this question three daily dosages (3, 1, 0.5 mg) were administered and the hormone profiles obtained as well as the number of oocytes retrieved, the fertilization rate, and the consumption of HMG were compared.
Results: No premature LH surge could be observed at any of the three dosages administered. Both gonadotropins were deeply suppressed. The fertilization rates of the oocytes obtained were 45.3% in the 3-mg group, 53.1% in the 1-mg group, and 67.7% in the 0.5-mg group. The average uses of hMG ampoules were 30 in the 3-mg group, 27 in the 1-mg group, and 26 in the 0.5-mg group.
Conclusions: Cetrolix, 0.5 mg/day, administered during the midcycle phase of controlled ovarian hyperstimulation with hMG is enough to prevent completely the premature LH surge. Perhaps even lower dosages would be sufficient. Regarding fertilization rates and use of hMG, the lower dosage seems to be the most favorable.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Matsou H, Baba Y, Nair RMG, Arimura A, Schall AV: Structure of porcine LH and FSH releasing factor. I. The proposed amino acid sequence. Biochem Biophys Res Commun 1971;43:1334–1339
Burgus R, Butcher M, Amoss M,et al.: Primary structure of the ovine hypothalamic luteinizing hormone releasing factor (LRF). Proc Natl Acad Sci USA 1972;69:278–282
Clayton RN: Gonadotropin-releasing hormone: Its actions and receptors. J Endocrinol 1989;120:11–19
Meldrum DR, Tsao Z, Monroe SE,et al.: Stimulation of LH fragments with reduced bioactivity following GnRH agonist administration in women. J Clin Endocrinol Metab 1984;58:755–757
Dahl KD, Pavlou SN, Kovacs WJ, Hsueh AJW: The changing ratio of serum bioactive to immunoreactive follicle-stimulating hormone in normal men following treatment with a potent gonadotropin releasing hormone antagonist. J Clin Endocrinol Metab 1986;63:792–794
Kiesel L, Runnebaum B: Gonadotropin-releasing-Hormon und Analoga—Physiologie und Pharmakologie. Gynäkol Geburtsh rundsch 1992;32:22–30
Lemay A, Maheux R, Faure N, Jean C, Fazekas ATA: Reversible hypogonadism induced by a luteinizing hormone releasing hormone (LH-RH) agonist (Buserelin) as a new therapeutic approach for endometriosis. Fertil Steril 1984;41:863–871
Klingmüller D, Schepke M, Enzweiler C, Bidlingmaier F: Hormonal response to the new potent GnRH-antagonist Cetrorelix. Acta Endocrinol 1993;128:15–18
Klingmüller D, Diedrich K, Sommer L: Effects of the GnRH-antagonist Cetrorelix in normal women. Gynecol Endocrinol 1993;7:2
Dittkoff EC, Cassidenti DL, Paulson RJ, Sauer MV, Wellington LP, Rivier J, Yen SCC, Lobo RA: The gonadotropin-releasing-hormone antagonist (Nal-Glu) acutely blocks the luteinizing hormone surge but allows for resumption of folliculogenesis in normal women. Am J Obstet Gynecol 1991;165:1811–1817
Stanger JD, Yovich JL: Reduced in vitro fertilization of human oocytes from patients with raised basal luteinizing hormone levels during the follicular phase. Br J Obstet Gynecol 1985;92:385–393
Loumeye E: The control of endogenous secretion of LH by gonadotrophin-releasing hormone agonists during ovarian hyperstimulation for in vitro fertilization and embryo transfer. Hum Reprod 1990;5:357–376
Diedrich K, Diedrich C, Santos E, Zoll C, Al-Hasani S, Reissmann T, Krebs D, Klingmüller D: Suppression of the endogenous luteinizing hormone surge by the gonadotropin-releasing hormone antagonist Cetrorelix during ovarian stimulation. Hum Reprod 1994;9:788–791
Felberbaum RE, Reissmann T, Küpker W, Bauer O, Al-Hasani S, Diedrich C, Diedrich K: Preserved pituitary response under ovarian stimulation with HMG and GnRH-antagonists (Cetrorelix) in women with tubal infertility. Eur J Obstet Gynecol Reprod Biol 1995;61:151–155
Olivennes F, Fanchin R, Bouchard P, DeZiegler D, Taieb J, Selva J, Frydman R: The single or dual administration of the gonadotropin-releasing-hormone antagonist Cetrorelix in an in vitro fertilization-embryo transfer program. Fertil Steril 1994;62:468–476
Diedrich K, Van der Ven H, Krebs D: Physiologie der Reproduktion. In Krebs D (Hersg.), Reproduktion-Störung in der Frühgravidität. Klinik Frauenheil Geburtsh 1985;3:5–83
Staessen C, Camus M, Khan I, Smitz J, Van Waesberghe L, Wisanto A, Devroey P, Van Steirteghem AC: An 18-month survey of infertility treatment by in vitro fertilization, gamete and zygote intrafallopian transfer, and replacement of frozen thawed embryos. J Vitro Fertil Embryo Transfer 1989;6:22–29
Keller R, Günther HL, Kaiser P: Embryonenschutzgesetz. Stuttgart-Berlin-Köln, Verlag W. Kohlhammer, 1992
Smitz J, Ron-El R, Tarlatzis BC: The use of gonadotrophin releasing hormone agonists for in vitro fertilization and other assisted procreation techniques: Experience from three centres. Hum Reprod 1992;7 (Suppl 1):49–66
Pellicer A, Miro F: Steroidogenesis in vitro of human granulosa lutealcells pretreated in vivo with gonadotropin-releasing hormone analogs. Fertil Steril 1990;54:590–596
Latouche J, Crmeyrolle-Arias M, Jordan D, Kopp N, Augende-Ferrante B, Cedard L, Haour F: GnRH receptors in human granulosa cells: Anatomical localization and charakterization by autoradiographic study. Endocrinology 1989;125:1739–1741
Thompson KA, LaPolt PS, Rivier J, Henderson Gogy Dahl KD, Meldrum DR: Gonadotropin requirements of the developing follicle. Fertil Steril 1995;63:273–276
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Felberbaum, R., Reissmann, T., Küpker, W. et al. Hormone profiles under ovarian stimulation with human menopausal gonadotropin (hMG) and concomitant administration of the gonadotropin releasing hormone (GnRH)-antagonist Cetrorelix at different dosages. J Assist Reprod Genet 13, 216–222 (1996). https://doi.org/10.1007/BF02065939
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02065939