The impact of a gonadotropin-releasing hormone antagonist on gonadotropin ovulation induction cycles in women with polycystic ovary syndrome: a prospective randomized study

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• 作者：Laurel A. Stadtmauer ; Abbaa Sarhan ; E. Hakan Duran ; Hind Beydoun ; Silvina Bocca ; Beth Pultz ; Sergio Oehninger
• 关键词：Ovulation induction ; IUI ; GnRH antagonist ; PCOS
• 刊名：Fertility and Sterility
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：95
• 期：1
• 页码：216-220
• 全文大小：143 K

文摘

Objective

To evaluate the effect of the gonadotropin-releasing hormone antagonist Ganirelix on gonadotropin ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS).

Design

Prospective, randomized, controlled study.

Setting

Academic infertility center.

Patient(s)

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

Intervention(s)

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.

Main Outcome Measure(s)

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.

Result(s)

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.

Conclusion(s)

Adding Ganirelix in a flexible protocol to gonadotropin OI cycles in women with PCOS may be beneficial by decreasing premature luteinization.