[Use of GnRh antagonist (Cetrorelix) in controlled ovarian hyperstimulation in women with polycystic ovary disease].

OBJECTIVE

to evaluate the results of the use of GnRH antagonist (GnRH ant) cetrorelix and GnRH analog (GnRH a) in two matched groups of OPK ICSI patients in a retrospective matched pair analysis.

METHODS

patients (n = 201 ) were stimulated with recombinant FSH (rFSH). In group A (n = 98), a dose of 3 mg of Cetrorelix was administered when follicles reached a diameter of > 14 mm. Patients in group B (n = 103) were first desensitized with GnRHa triptorelin long protocol.

RESULTS

The mean lenth of stimulation, and the dose of FSH required per patient were significantly higher in group B: (11.2 +/- 1.9j vs 9.7 +/- 0.7j p < 0.001) and (2209.0 +/- 548.3 vs 1411.1 +/- 217.9: p < 0.001) respectively. The mean E2 level on day of hCG administration was significantly higher in the patients of group B (3347.85 +/- 99 vs 2354.45 +/- 839: p < 0.001), however, a progressive increase in serum E2 concentration during the cycle were noted in both groups. A median of 15.9 +/- 5.9 and 17.3 +/- 8.3, (p = 0.159) retrieved oocytes per patients was obtained respectively in group A and B. The median of mature oocytes per patient were similar in both groups (11.43 +/- 4.2 in group A vs 11.9 +/- 6.4 in group B: p = 0.526). Pregnancy rate were better in group B (31.1 vs 28.6% p = 0.69). No severe ovarian hyperstimulation (OHSS) occurred in group A vs 3 cases in group B.

CONCLUSION

GnRHant and GnRHa provide comparable results in OPK patient, while GnRHant allows a higher flexibility in treatment, a lower dose of FSH required and a shorter period of stimulation.