Human Reproduction, Vol. 17, No. 11, 2842-2845,
November 2002
© 2002 European Society of Human Reproduction and Embryology
Tailoring the GnRH antagonist cetrorelix acetate to individual patients’ needs in ovarian stimulation for IVF: results of a prospective, randomized study
1 Division of Reproductive Medicine and Gynecologic Endocrinology, 2 Department of Gynecology and Obstetrics, University Clinic, Ratzeburger Allee 160, 23538 Lübeck and 3 Department of Cancer Epidemiology and Social Medicine, Medical University Lübeck, Beckergrube 42–44, 23552 Lübeck, Germany
INTRODUCTION: This study was performed to evaluate whether a tailored approach to the administration of the GnRH antagonist cetrorelix acetate according to follicular size leads to a reduction in the amount of Cetrotide® vials used and/or an increased number of monitoring visits. METHODS: Sixty patients were prospectively randomized (using sealed envelopes) to receive either the fixed multiple dose antagonist protocol starting on day 6 of stimulation (group 1), or an individualized protocol with the time of antagonist start according to follicle size (14 mm, group 2), or an individualized single dose protocol (group 3). Recombinant human (rh)FSH was used. The primary endpoints were the number of Cetrotide vials and number of monitoring visits. Statistical power for the parameter Cetrotide vials was 80%. RESULTS: Patients in group 1 needed significantly more Cetrotide vials (6.81 ± 1.61) than patients of group 2 (4.59 ± 1.65; P < 0.01). The number of monitoring visits was similar between the three groups. Surprisingly, the number of retrieved oocytes was significantly higher in the individualized groups as compared with group 1. Despite a significantly lower total amount of rhFSH used, estradiol levels were significantly higher in group 2 as compared with group 1. CONCLUSION: Tailoring of GnRH antagonist protocols leads to an optimization of ovarian stimulation with more oocytes retrieved despite less rhFSH used, and the same number of monitoring visits.
Key words:
cetrorelix/follitropin 
/GnRH antagonist/ovarian stimulation/recombinant FSH
4 To whom correspondence should be addressed. E-mail: Ludwig_m{at}t-online.de
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