Prospective, randomized, controlled study of in vitro fertilization-embryotransfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin)

Objective: To confirm the value of a single dose of 3 mg of cetrorelix in p reventing the occurrence of premature LH surges. Design: Multicenter randomized, prospective study. Setting: Reproductive medicine units. Patient(s): Infertile patients undergoing ovarian stimulation for IVF-ET. Intervention(s): A single dose of 3 mg of cetrorelix (Cetrotide; ASTA Medic a, FrankFurt, Germany) (115 patients) was administered in the late follicul ar phase. A depot preparation of triptorelin (Decapeptyl; Ipsen-Biotech, Pa ris, France) was chosen as a control agent (39 patients). Ovarian stimulati on was conducted With hMG (Menogon; Ferring, Kiel, Germany). Main Outcome Measure(s): Premature LH surges (LH level >10 IU/L), progester one level greater than 1 ng/L, and NF results. Result(s): No LH surge occurred after cetrorelix administration. The patien ts in the cetrorelix group had a lower number of oocytes and embryos. The p ercentage of mature oocytes and fertilization rates were similar in both gr oups, and the pregnancy rates were not statistically different. The length of stimulation, number of hMG ampules administered, and occurrence of the o varian hyperstimulation syndrome were lower in the cetrorelix group. Tolera nce of cetrorelix was excellent. Conclusion(s): A cetrorelix single-dose protocol prevented LH surges in all patients studied. It compares favorably to the "long protocol" and could b e a protocol of choice in IVF-ET. (Fertil Steril(R) 2000;73:314-20. (C)2000 by American Society for Reproductive Medicine.).