[Use of GNRH antagonist [cetrorelix] in controlled ovarian hyperstimulation in women with polycystic ovary disease]

ABSTRACT

To evaluate the results of the use of GnRH antagonist [GnRH ant] cetrorelix and GnRH analog [GnRH a] in two matched groups of OPK ICSI patients in a restrospective matched pair analysis. Patients [n = 201] were stimulated with recombinant FSH [rFSH]. In group A [n=98], a dose of 3 mg of Cetrorelix was administred when follicles reached a diameter of> 14 mm. Patients in group B [n=103] were first desensitized with GnRHa triptorelin long protocol. The mean length of stimulation, and the dose of FSH required per patient were significantly higher in group B [11,2 +/- l,9j vs9,7 +/- 0,7jp<0,00l] and [2209,0 +/- 548,3vs 1411,1 +/- 2179 p<0,001] respectively. The mean E2 level on day of hCG administration was significantly higher in the patients of group B [3347,85 +/- 99 vs 2354,45 +/- 839 p<0,001], however, a progressive increase in serum E2 concentration during the cycle were noted in both groups. A median of 15,9 +/- 5,9 and 17,3 +/- 8,3 [p =0,159 retrived oocytes per patients was obtained respectively in group A and B. The median of mature oocytes per patient were similar in both groups [11,43 +/- 4,2 in group A vs 11,9 +/- 6,4 in group B p=0,526]. Pregnancy rate were better in group B [31,1 vs 28,6% p = 0,69]. No severe ovarian hyperstimulation [OHSS] occured in group A vs 3 cases in group B. GnRHant and GnRHa provide comparable results in OPK patient, while GnRHant allows a higher flexibility in treatment, a lower dose of FSH required and a shorter period of stimulation