Effectiveness of cetrorelix for the prevention of premature luteinizing hormone surge during controlled ovarian stimulation using letrozole and gonadotropins: a randomized trial

Tsung Hsien Lee, Yu Hung Lin, Kok Min Seow, Jiann-Loung Hwang, Chii Ruey Tzeng, Yu Shih Yang

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Objective: To evaluate the effectiveness of a GnRH antagonist in preventing premature LH surge under a letrozole and gonadotropin protocol. Design: Prospective, randomized clinical trial. Setting: A teaching hospital and tertiary medical center. Patient(s): Sixty-one patients were randomly assigned into two letrozole and gonadotropin-treated groups. These were distinguished by the absence (group I) or presence (group II) of supplementation with 0.25 mg of cetrorelix. Intervention(s): Controlled ovarian stimulation with letrozole and gonadotropins, cetrorelix and intrauterine insemination. Main Outcome Measure(s): Rate of premature LH surge. Result(s): Compared with group I, the rate of premature LH surge was statistically significantly lower for group II (43.4% [13/30] vs. 19.4% [6/31]), but the amount of gonadotropins used was statistically significantly higher (817.5 ± 28.5 vs. 907.5 ± 27.3 IU). Patients with premature LH surge had a statistically significantly lower pregnancy rate (21.4% [9/42] vs. 0 [0/18]) relative to their unaffected counterparts. Conclusion(s): A flexible protocol of 0.25 mg of cetrorelix for IUI cycles appears to suppress the rate of premature LH surge during ovarian stimulation with letrozole and gonadotropins. However, the incidence of premature LH surge remains too high, and modification will be necessary before the application of cetrorelix to IVF treatment.

Original languageEnglish
Pages (from-to)113-120
Number of pages8
JournalFertility and Sterility
Volume90
Issue number1
DOIs
Publication statusPublished - Jul 2008

Keywords

  • Aromatase inhibitor
  • GnRH antagonist
  • ovulation induction
  • pregnancy
  • premature LH surge

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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