Cetrotide administration in the early luteal phase in patients at high risk of ovarian hyperstimulation syndrome: A controlled clinical study

Wang,Ya‑Qin; Yu,Nan; Xu,Wang‑Min; Xie,Qin‑Zhen; Yan,Wen‑Jie; Wu,Geng‑Xiang; Yang,Jing

doi:10.3892/etm.2014.2005

Cetrotide administration in the early luteal phase in patients at high risk of ovarian hyperstimulation syndrome: A controlled clinical study

Authors:
- Ya‑Qin Wang
- Nan Yu
- Wang‑Min Xu
- Qin‑Zhen Xie
- Wen‑Jie Yan
- Geng‑Xiang Wu
- Jing Yang
View Affiliations

Affiliations: Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, P.R. China
Published online on: October 6, 2014 https://doi.org/10.3892/etm.2014.2005
Pages: 1855-1860

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present pilot study was to assess the feasibility and efficacy of Cetrotide administration in the early luteal phase in patients at high risk of ovarian hyperstimulation syndrome (OHSS), undergoing embryo cryopreservation following superovulation. A total of 135 patients at high risk of OHSS and undergoing embryo cryopreservation were divided into two groups. In the treatment group (n=39), the patients received daily subcutaneous injections of 0.25 mg Cetrotide between days 1 and 5 following ooctye retrieval, and volume expansion and symptomatic treatment were also provided. In the control group (n=96), the patients received routine treatments, including volume expansion therapy. The serum steroid hormone concentrations of the patients were measured on days 2, 5 and 8 following ooctye retrieval, while the incidence of moderate or severe OHSS, self‑evaluated clinical symptoms and various clinical indicators were recorded. The serum estradiol (E2), luteinizing hormone and progesterone levels in the treatment group on days 2, 5 and 8 following oocyte retrieval were not found to differ significantly when compared with the patients in the control group (P>0.05). The incidence of severe OHSS did not differ significantly between the two groups (P>0.05). The average length of hospital stay and length of luteal phase were not found to be significantly different between the treatment and control groups (P>0.05). In conclusion, Cetrotide injections in the early luteal phase did not alter the serum steroid levels of patients at high risk of OHSS undergoing embryo cryopreservation, and were unable to reduce the incidence of severe early OHSS. However, further randomized studies are required to evaluate the effectiveness of Cetrotide in the prevention of OHSS.

View Figures

View References

1	Aboulghar M: Prediction of ovarian hyperstimulation syndrome (OHSS). Estradiol level has an important role in the prediction of OHSS. Hum Reprod. 18:1140–1141. 2003. View Article : Google Scholar : PubMed/NCBI
2	Kamath MS, Joshi A, Kamath AM and Aleyamma T: Management of severe ovarian hyperstimulation syndrome with thawed plasma. J Hum Reprod Sci. 6:82–85. 2013. View Article : Google Scholar : PubMed/NCBI
3	de Mouzon J, Goossens V, Bhattacharya S, Castilla JA, Ferraretti AP, Korsak V, Kupka M, Nygren KG and Nyboe Andersen A: European IVF-monitoring (EIM) Consortium, for the European Society of Human Reproduction and Embryology (ESHRE): Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE. Hum Reprod. 25:1851–1862. 2010.
4	Gilliam ML: Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. Obstet Gynecol. 118:706–707. 2011. View Article : Google Scholar : PubMed/NCBI
5	Lainas TG, Sfontouris IA, Zorzovilis IZ, Petsas GK, Lainas GT and Kolibianakis EM: Management of severe early ovarian hyperstimulation syndrome by re-initiation of GnRH antagonist. Reprod Biomed Online. 15:408–412. 2007. View Article : Google Scholar : PubMed/NCBI
6	Bonilla-Musoles FM, Raga F, Castillo JC, Sanz M, Dolz M and Osborne N: High doses of GnRH antagonists are efficient in the management of severe ovarian hyperstimulation syndrome. Clin Exp Obstet Gynecol. 36:78–81. 2009.PubMed/NCBI
7	Golan A, Ron-el R, Herman A, Soffer Y, Weinraub Z and Caspi E: Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Surv. 44:430–440. 1989. View Article : Google Scholar : PubMed/NCBI
8	Aboulghar MA and Mansour RT: Ovarian hyperstimulation syndrome: classifications and critical analysis of preventive measures. Hum Reprod Update. 9:275–289. 2003. View Article : Google Scholar : PubMed/NCBI
9	Gómez R, Soares SR, Busso C, Garcia-Velasco JA, Simón C and Pellicer A: Physiology and pathology of ovarian hyperstimulation syndrome. Semin Reprod Med. 28:448–457. 2010.
10	Egbase PE: Severe OHSS: how many cases are preventable? Hum Reprod. 15:8–10. 2000. View Article : Google Scholar : PubMed/NCBI
11	Humaidan P, Quartarolo J and Papanikolaou EG: Preventing ovarian hyperstimulation syndrome: guidance for the clinician. Fertil Steril. 94:389–400. 2010. View Article : Google Scholar : PubMed/NCBI
12	Fatemi HM, Popovic-Todorovic B, Donoso P, Papanikolaou E, Smitz J and Devroey P: Luteal phase oestradiol suppression by letrozole: a pilot study in oocyte donors. Reprod Biomed Online. 17:307–311. 2008. View Article : Google Scholar : PubMed/NCBI
13	Garcia-Velasco JA: How to avoid ovarian hyperstimulation syndrome: a new indication for dopamine agonists. Reprod Biomed Online. 18(Suppl 2): 71–75. 2009. View Article : Google Scholar : PubMed/NCBI
14	Gurgan T, Demirol A, Guven S, Benkhalifa M, Girgin B and Li TC: Intravenous calcium infusion as a novel preventive therapy of ovarian hyperstimulation syndrome for patients with polycystic ovarian syndrome. Fertil Steril. 96:53–57. 2011. View Article : Google Scholar : PubMed/NCBI
15	Papanikolaou EG, Polyzos NP, Humaidan P, Pados G, Bosch E, Tournaye H and Tarlatzis B: Aromatase inhibitors in stimulated IVF cycles. Reprod Biol Endocrinol. 9:852011. View Article : Google Scholar : PubMed/NCBI
16	Rollene NL, Amols MH, Hudson SB and Coddington CC: Treatment of ovarian hyperstimulation syndrome using a dopamine agonist and gonadotropin releasing hormone antagonist: a case series. Fertil Steril. 92:1169.e15–1169.e17. 2009. View Article : Google Scholar : PubMed/NCBI
17	Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J and Abou-Setta AM: Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. Cochrane Database Syst Rev. CD0017502011.
18	Hill MJ, Chason RJ, Payson MD, Segars JH and Csokmay JM: GnRH antagonist rescue in high responders at risk for OHSS results in excellent assisted reproduction outcomes. Reprod Biomed Online. 25:284–291. 2012. View Article : Google Scholar : PubMed/NCBI
19	Hosseini MA, Mahdavi A, Aleyasin A, Safdarian L and Bahmaee F: Treatment of ovarian hyperstimulation syndrome using gonadotropin releasing hormone antagonist: a pilot study. Gynecol Endocrinol. 28:853–855. 2012. View Article : Google Scholar : PubMed/NCBI
20	Asimakopoulos B, Nikolettos N, Nehls B, Diedrich K, Al-Hasani S and Metzen E: Gonadotropin-releasing hormone antagonists do not influence the secretion of steroid hormones but affect the secretion of vascular endothelial growth factor from human granulosa luteinized cell cultures. Fertil Steril. 86:636–641. 2006. View Article : Google Scholar
21	McDonough PG: Vascular endothelial growth factor - mediator of OHSS? Fertil Steril. 79:1466–1467. 2003. View Article : Google Scholar : PubMed/NCBI
22	Alvarez C, Alonso-Muriel I, García G, Crespo J, Bellver J, Simón C and Pellicer A: Implantation is apparently unaffected by the dopamine agonist Cabergoline when administered to prevent ovarian hyperstimulation syndrome in women undergoing assisted reproduction treatment: a pilot study. Hum Reprod. 22:3210–3214. 2007. View Article : Google Scholar
23	Kosaka K, Fujiwara H, Yoshioka S and Fujii S: Vascular endothelial growth factor production by circulating immune cells is elevated in ovarian hyperstimulation syndrome. Hum Reprod. 22:1647–1651. 2007. View Article : Google Scholar
24	Fridén BE and Nilsson L: Gonadotrophin-releasing hormone antagonist luteolysis during the preceding mid-luteal phase is a feasible protocol in ovarian hyperstimulation before in vitro fertilization. Acta Obstet Gynecol Scand. 84:812–816. 2005.
25	Duffy DM, Stewart DR and Stouffer RL: Titrating luteinizing hormone replacement to sustain the structure and function of the corpus luteum after gonadotropin-releasing hormone antagonist treatment in rhesus monkeys. J Clin Endocrinol Metab. 84:342–349. 1999.
26	Ortmann O, Weiss JM and Diedrich K: Embryo implantation and GnRH antagonists: ovarian actions of GnRH antagonists. Hum Reprod. 16:608–611. 2001. View Article : Google Scholar : PubMed/NCBI