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Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following Diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study.
Hum Reprod. 2004 Sep; 19(9):1993-2000.HR

Abstract

BACKGROUND

Patients with polycystic ovary syndrome (PCOS) may need a longer period of pituitary downregulation to suppress the elevated serum LH and androgen levels effectively during IVF treatment using the GnRH agonist long protocol. We proposed a stimulation protocol incorporating Diane-35 and GnRH antagonist (Diane/cetrorelix protocol) and compared it with the GnRH agonist long protocol for PCOS patients.

METHODS

Part I of the study was an observational pilot study to evaluate the hormonal change as a result of the Diane/cetrorelix protocol (n = 26). Part II of the study was a prospective randomized study comparing the Diane/cetrorelix protocol (n = 25) and the GnRH agonist long protocol (n = 24). In the Diane/cetrorelix protocol, patients were pre-treated with three cycles of Diane-35, followed by 0.25 mg of cetrorelix on cycle day 3. From day 4, cetrorelix and gonadotrophin were administered concomitantly until the day of HCG injection.

RESULTS

Serum LH, estradiol and testosterone levels were suppressed comparably in both protocols at the start of gonadotrophin administration. Serum LH was suppressed at constant levels without a premature LH surge in the Diane/cetrorelix protocol. The clinical results for both protocols were comparable, with significantly fewer days of injection, lower amounts of gonadotrophin used and lower estradiol levels on the day of HCG injection following the Diane/cetrorelix protocol. Furthermore, there was no significant difference in clinical pregnancy outcome between the two stimulation protocols.

CONCLUSIONS

The Diane/cetrorelix protocol has a similar pregnancy outcome to the GnRH agonist long protocol for women with PCOS undergoing IVF treatment.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. m001015@ms.skh.org.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15284212

Citation

Hwang, Jiann-Loung, et al. "Ovarian Stimulation By Concomitant Administration of Cetrorelix Acetate and HMG Following Diane-35 Pre-treatment for Patients With Polycystic Ovary Syndrome: a Prospective Randomized Study." Human Reproduction (Oxford, England), vol. 19, no. 9, 2004, pp. 1993-2000.
Hwang JL, Seow KM, Lin YH, et al. Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following Diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study. Hum Reprod. 2004;19(9):1993-2000.
Hwang, J. L., Seow, K. M., Lin, Y. H., Huang, L. W., Hsieh, B. C., Tsai, Y. L., Wu, G. J., Huang, S. C., Chen, C. Y., Chen, P. H., & Tzeng, C. R. (2004). Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following Diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study. Human Reproduction (Oxford, England), 19(9), 1993-2000.
Hwang JL, et al. Ovarian Stimulation By Concomitant Administration of Cetrorelix Acetate and HMG Following Diane-35 Pre-treatment for Patients With Polycystic Ovary Syndrome: a Prospective Randomized Study. Hum Reprod. 2004;19(9):1993-2000. PubMed PMID: 15284212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following Diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study. AU - Hwang,Jiann-Loung, AU - Seow,Kok-Min, AU - Lin,Yu-Hung, AU - Huang,Lee-Wen, AU - Hsieh,Bih-Chwen, AU - Tsai,Yieh-Loong, AU - Wu,Gong-Jhe, AU - Huang,Shih-Chia, AU - Chen,Chin-Yu, AU - Chen,Pei-Hsin, AU - Tzeng,Chii-Ruey, Y1 - 2004/07/29/ PY - 2004/7/31/pubmed PY - 2005/3/10/medline PY - 2004/7/31/entrez SP - 1993 EP - 2000 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 19 IS - 9 N2 - BACKGROUND: Patients with polycystic ovary syndrome (PCOS) may need a longer period of pituitary downregulation to suppress the elevated serum LH and androgen levels effectively during IVF treatment using the GnRH agonist long protocol. We proposed a stimulation protocol incorporating Diane-35 and GnRH antagonist (Diane/cetrorelix protocol) and compared it with the GnRH agonist long protocol for PCOS patients. METHODS: Part I of the study was an observational pilot study to evaluate the hormonal change as a result of the Diane/cetrorelix protocol (n = 26). Part II of the study was a prospective randomized study comparing the Diane/cetrorelix protocol (n = 25) and the GnRH agonist long protocol (n = 24). In the Diane/cetrorelix protocol, patients were pre-treated with three cycles of Diane-35, followed by 0.25 mg of cetrorelix on cycle day 3. From day 4, cetrorelix and gonadotrophin were administered concomitantly until the day of HCG injection. RESULTS: Serum LH, estradiol and testosterone levels were suppressed comparably in both protocols at the start of gonadotrophin administration. Serum LH was suppressed at constant levels without a premature LH surge in the Diane/cetrorelix protocol. The clinical results for both protocols were comparable, with significantly fewer days of injection, lower amounts of gonadotrophin used and lower estradiol levels on the day of HCG injection following the Diane/cetrorelix protocol. Furthermore, there was no significant difference in clinical pregnancy outcome between the two stimulation protocols. CONCLUSIONS: The Diane/cetrorelix protocol has a similar pregnancy outcome to the GnRH agonist long protocol for women with PCOS undergoing IVF treatment. SN - 0268-1161 UR - https://www.unboundmedicine.com/medline/citation/15284212/Ovarian_stimulation_by_concomitant_administration_of_cetrorelix_acetate_and_HMG_following_Diane_35_pre_treatment_for_patients_with_polycystic_ovary_syndrome:_a_prospective_randomized_study_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/deh375 DB - PRIME DP - Unbound Medicine ER -