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Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial.
Fertil Steril. 2011 Feb; 95(2):558-62.FS

Abstract

OBJECTIVE

To evaluate whether the incidence of luteinizing hormone (LH) rise is reduced by using a flexible compared with a fixed day-6 protocol of GnRH antagonist administration.

DESIGN

Randomized controlled trial.

SETTING

Tertiary university hospital.

PATIENT(S)

Patients undergoing in vitro fertilization (n = 146).

INTERVENTION(S)

Ovarian stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist cetrorelix (0.25 mg/d) was started either on day 6 of stimulation (fixed group) or when LH was >10 IU/L, and/or a follicle with mean diameter >12 mm was present, and/or serum E(2) was >150 pg/mL. Patient monitoring was initiated on day 3 of stimulation.

MAIN OUTCOME MEASURE(S)

Incidence of LH rise.

RESULT(S)

No statistically significant difference was observed between the flexible and fixed groups regarding the incidence of LH rise, which was lower in the flexible group (11.0% vs. 15.1%, difference -4.1%, 95% confidence interval -15.4% to +7.1%). No LH surges were observed in any of the patients studied.

CONCLUSION(S)

Flexible antagonist administration from day 3 onward does not appear to reduce the incidence of LH rises compared with fixed antagonist administration on day 6 of stimulation.

Authors+Show Affiliations

Unit for Human Reproduction, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20637457

Citation

Kolibianakis, Efstratios M., et al. "Fixed Versus Flexible Gonadotropin-releasing Hormone Antagonist Administration in in Vitro Fertilization: a Randomized Controlled Trial." Fertility and Sterility, vol. 95, no. 2, 2011, pp. 558-62.
Kolibianakis EM, Venetis CA, Kalogeropoulou L, et al. Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial. Fertil Steril. 2011;95(2):558-62.
Kolibianakis, E. M., Venetis, C. A., Kalogeropoulou, L., Papanikolaou, E., & Tarlatzis, B. C. (2011). Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial. Fertility and Sterility, 95(2), 558-62. https://doi.org/10.1016/j.fertnstert.2010.05.052
Kolibianakis EM, et al. Fixed Versus Flexible Gonadotropin-releasing Hormone Antagonist Administration in in Vitro Fertilization: a Randomized Controlled Trial. Fertil Steril. 2011;95(2):558-62. PubMed PMID: 20637457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fixed versus flexible gonadotropin-releasing hormone antagonist administration in in vitro fertilization: a randomized controlled trial. AU - Kolibianakis,Efstratios M, AU - Venetis,Christos A, AU - Kalogeropoulou,Lydia, AU - Papanikolaou,Evangelos, AU - Tarlatzis,Basil C, Y1 - 2010/07/16/ PY - 2010/02/05/received PY - 2010/05/13/revised PY - 2010/05/14/accepted PY - 2010/7/20/entrez PY - 2010/7/20/pubmed PY - 2011/3/1/medline SP - 558 EP - 62 JF - Fertility and sterility JO - Fertil. Steril. VL - 95 IS - 2 N2 - OBJECTIVE: To evaluate whether the incidence of luteinizing hormone (LH) rise is reduced by using a flexible compared with a fixed day-6 protocol of GnRH antagonist administration. DESIGN: Randomized controlled trial. SETTING: Tertiary university hospital. PATIENT(S): Patients undergoing in vitro fertilization (n = 146). INTERVENTION(S): Ovarian stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist cetrorelix (0.25 mg/d) was started either on day 6 of stimulation (fixed group) or when LH was >10 IU/L, and/or a follicle with mean diameter >12 mm was present, and/or serum E(2) was >150 pg/mL. Patient monitoring was initiated on day 3 of stimulation. MAIN OUTCOME MEASURE(S): Incidence of LH rise. RESULT(S): No statistically significant difference was observed between the flexible and fixed groups regarding the incidence of LH rise, which was lower in the flexible group (11.0% vs. 15.1%, difference -4.1%, 95% confidence interval -15.4% to +7.1%). No LH surges were observed in any of the patients studied. CONCLUSION(S): Flexible antagonist administration from day 3 onward does not appear to reduce the incidence of LH rises compared with fixed antagonist administration on day 6 of stimulation. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/20637457/Fixed_versus_flexible_gonadotropin_releasing_hormone_antagonist_administration_in_in_vitro_fertilization:_a_randomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(10)00924-6 DB - PRIME DP - Unbound Medicine ER -