A Study for Clinical Efficacy of GnRH Antagonist (Cetrorelix) Minimal Stimulation Protocol in Assisted Reproductive Techniques for Polycystic Ovaian Syndrome.

Park,  Sung Dae; Lee,  Sang Hoon

Original Article

Korean Journal of Fertility and Sterility 2002;29(4):251-258.
Published online December 1, 2002.

A Study for Clinical Efficacy of GnRH Antagonist (Cetrorelix) Minimal Stimulation Protocol in Assisted Reproductive Techniques for Polycystic Ovaian Syndrome.

Sung Dae Park, Sang Hoon Lee

Department of Obstetrics and Gynecology, College of Medicine, Chung-Ang University, Seoul, Korea.

Abstract

OBJECTIVE
The aim of this study was to evaluate the outcomes of the GnRH antagonist (Cetrotide) minimal stimulation protocol comparing with GnRH agonist combined long step down stimulation protocol in PCOS patients. MATERIALS AND METHOD: From Apr 2001 to May 2002, 22 patients (22 cycles) were performed in controlled ovarian hyperstimulation using by GnRH antagonist and GnRH agonist for PCOS patients. GnRH antagonist (Cetrotide) combined minimal stimulation protocol was administered in 10 patients (10 cycles, Study Group) and GnRH agonist long step down stimulation protocol was administered in 12 patients (12 cycles, Control Group). We compared the pregnancy rate/cycle, total FSH (A)/cycle, Retrieved oocyte/cycle, the incidence of ovarian hyperstimulation syndrome, multiple pregnancy rate between the two groups. Student-t test were used to determine statistical significance. Statistical significance was defined as p<0.05. RESULTS: Group of GnRH antagonist (Cetrorelix) minimal stimulation protocol produced fewer oocytes (6.4 versus 16.3 oocytes/cycle) using a lower dose of FSH (22.2 versus 36.1 Ample/cycle) and none developed OHSS and multiple pregnancy. Although the trends were in favour of the GnRH antagonist (Cetrorelix) protocol, the differences did not reach statistical significance. This was probably due to small sample size. CONCLUSION: The use of GnRH antagonist reduce the risk of ovarian hyperstimulation and multiple pregnancy. We suggest that GnRH antagonist might be alternative controlled ovarian hyperstimulation method, especially in PCOS patients who will be ovarian high response.

Key Words: GnRH antagonist; Ovarian hyperstimulation syndrome; Multiple pregnancy; PCOS