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Human Reproduction, Vol. 18, No. 1, 45-49, January 2003
© 2003 European Society of Human Reproduction and Embryology

Ovarian stimulation by clomiphene citrate and hMG in combination with cetrorelix acetate for ICSI cycles

Jiann-Loung Hwang, Lee-Wen Huang, Bih-Chwen Hsieh, Yieh-Loong Tsai, Shih-Chia Huang, Chin-Yu Chen, Mei-Ling Hsieh, Pei-Hsin Chen and Yu-Hung Lin1

Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan 1 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, Shin-Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih Lin District, Taipei, Taiwan. e-mail: m002179{at}ms.skh.org.tw

BACKGROUND: The introduction of GnRH antagonists such as cetrorelix acetate has made possible the simplification of ovarian stimulation. However, the most effective protocol for their administration has not yet been clearly defined. METHODS: Forty women with male-factor infertility undergoing 40 ICSI cycles were included in the study. Clomiphene citrate at 100 mg a day was given from cycle day 3 through day 7. hMG at 150 IU was given on cycle days 4, 6 and 8, and was adjusted from day 9 according to the follicular and hormone responses. Cetrorelix acetate at 2.5 mg was administered when the leading follicle reached 14 mm. The remaining 0.5 mg was divided into two 0.25 mg injections for possible later use. Serum FSH, LH, estradiol and progesterone levels were measured daily from the day of cetrorelix acetate injection until hCG was given. RESULTS: Serum LH level was suppressed effectively for 4 days. Four patients (10%) needed one or two additional injections of 0.25 mg cetrorelix acetate. No premature LH surge was detected in any of the women treated. Sixteen women became pregnant (40%), of which 14 pregnancies (35%) were ongoing at the time of writing. CONCLUSIONS: This study demonstrates that this new protocol is feasible for couples with male-factor infertility undergoing ICSI.

Key words: cetrorelix acetate/clomiphene citrate/hMG/GnRH antagonist


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J.-L. Hwang, K.-M. Seow, Y.-H. Lin, L.-W. Huang, B.-C. Hsieh, Y.-L. Tsai, G.-J. Wu, S.-C. Huang, C.-Y. Chen, P.-H. Chen, 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., September 1, 2004; 19(9): 1993 - 2000.
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