Human Reproduction, Vol. 15, No. 3, 526-531,
March 2000
© 2000 European Society of Human Reproduction and Embryology
Ovarian stimulation with HMG: results of a prospective randomized phase III European study comparing the luteinizing hormone-releasing hormone (LHRH)-antagonist cetrorelix and the LHRH-agonist buserelin
1 Centre for Reproductive Medicine, Dutch-speaking Brussels Free University, Belgium, 2 Department of Obstetrics/Gynaecology of the Medical University of Lübeck, Germany, and 3 ASTA Medica AG, Frankfurt Main, Germany
In this prospective and randomized study, 188 patients received the luteinizing hormone-releasing hormone (LHRH) antagonist cetrorelix, and 85 patients the LHRH agonist buserelin to prevent endogenous luteinizing hormone (LH) surges during ovarian stimulation in in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Ultimately, 181 patients (96.3%) in the cetrorelix group, and 77 (90.6%) in the buserelin group, reached the day of the human chorionic gonadotrophin (HCG) injection. The mean number of human menopausal gonadotrophin (HMG) ampoules administered and the mean number of stimulation days with HMG were significantly less in the cetrorelix group than in the buserelin group (P < 0.01). A rise in LH and progesterone concentrations was observed in three of the 188 patients (1.6%) who received cetrorelix. On the day of the HCG administration, more follicles of a small diameter (11–14 mm) were observed in the buserelin group than in the cetrorelix group (P = 0.02) and the mean serum oestradiol concentration was significantly higher in patients who received buserelin than in those who received cetrorelix (P < 0.01). Similar results were observed in fertilization, cleavage and pregnancy rates in the two groups. In conclusion, the use of the LHRH antagonists might be considered more advantageous because of the short-term application needed to inhibit gonadotrophin secretion, so allowing a reduction in the treatment time in a clinically significant manner.
Key words: human menopausal gonadotrophins/LHRH antagonist/cetrorelix/LHRH agonist, buserelin
4 To whom correspondence should be addressed
§ Prof. Dr Paul Devroey, Prof. Dr André Van Steirteghem and Dr Carola Albano, Centre for Reproductive Medicine, Academic Hospital, Free University Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium; Prof. Dr Peter Brinsden and Dr F. Akagbosu, Bourn Hall Clinic, Cambridge CB3 7TR, UK; Dr Elizabeth Lenton, Dr Eswar Sundar, Dr S.E.Sugantha and Dr Medhat Fawzy, University of Sheffield, Sheffield Fertility Centre, 26 Glen Road, Sheffield S7 IRA, UK; Dr R.W.S.Yates, Prof. Dr R.Fleming and Dr E.Louis, University Department of Obstetrics and Gynaecology, Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK; Prof. Dr David Baird, Dr S.Lawson, Dr C.West and Dr D.Kinniburgh, University of Edinburgh, Centre of Reproductive Biology, 37 Chalmers Street, Edinburgh EH3 9EW, UK; Prof. Dr Johannes Evers, Dr J.A.Land, Dr J.W.M.Maas and Dr D.Courtar, Department of Obstetrics and Gynecology, Academic Hospital Maastricht, PO Box 5800, NL-6202 Maastricht, Netherlands; Prof. Dr Jarl Kahn and Dr F.Christensen, Ciconia Foundation, DK Copenhagen, Denmark.
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