Clin Exp Reprod Med.  2017 Dec;44(4):232-238. 10.5653/cerm.2017.44.4.232.

Reduction of the cetrorelix dose in a multiple-dose antagonist protocol and its impact on pregnancy rate and affordability: A randomized controlled multicenter study

• Dawood AS
• Algergawy
• Elhalwagy

• KMID: 2401626
• DOI: http://doi.org/10.5653/cerm.2017.44.4.232

Abstract

OBJECTIVE
To determine whether reducing the cetrorelix dose in the antagonist protocol to 0.125 mg had any deleterious effects on follicular development, the number and quality of retrieved oocytes, or the number of embryos, and to characterize its effects on the affordability of assisted reproductive technology.
METHODS
This randomized controlled study was conducted at the Fertility Unit of Tanta Educational Hospital of Tanta University, the Egyptian Consultants' Fertility Center, and the Qurrat Aien Fertility Center, from January 1 to June 30, 2017. Patients' demographic data, stimulation protocol, costs, pregnancy rate, and complications were recorded. Patients were randomly allocated into two groups: group I (n=61) received 0.125 mg of cetrorelix (the study group), and group II (n=62) received 0.25 mg of cetrorelix (the control group).
RESULTS
The demographic data were comparable regarding age, parity, duration of infertility, and body mass index. The dose of recombinant follicle-stimulating hormone units required was 2,350.43±150.76 IU in group I and 2,366.25±140.34 IU in group II, which was not a significant difference (p=0.548). The duration of stimulation, number of retrieved oocytes, and number of developed embryos were not significantly different between the groups. The clinical and ongoing pregnancy rates likewise did not significantly differ. The cost of intracytoplasmic sperm injection per cycle was significantly lower in group I than in group II (US $494.66±4.079 vs. US $649.677±43.637).
CONCLUSION
Reduction of the cetrorelix dose in the antagonist protocol was not associated with any significant difference either in the number of oocytes retrieved or in the pregnancy rate. Moreover, it was more economically feasible for patients in a low-resource country.

Keyword

Antagonist; Assisted reproductive techniques; Gonadotropins

MeSH Terms

Body Mass Index
Embryonic Structures
Female
Fertility
Follicle Stimulating Hormone
Gonadotropins
Humans
Infertility
Oocytes
Parity
Pregnancy Rate*
Pregnancy*
Reproductive Techniques, Assisted
Sperm Injections, Intracytoplasmic
Follicle Stimulating Hormone
Gonadotropins