The impact of a gonadotropin-releasing hormone antagonist on gonadotropin ovulation induction cycles in women with polycystic ovary syndrome: a prospective randomized study

Fertil Steril. 2011 Jan;95(1):216-20. doi: 10.1016/j.fertnstert.2010.05.023. Epub 2010 Jul 1.


Objective: To evaluate the effect of the gonadotropin-releasing hormone antagonist Ganirelix on gonadotropin ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS).

Design: Prospective, randomized, controlled study.

Setting: Academic infertility center.

Patient(s): Ninety-eight anovulatory women with PCOS undergoing 154 gonadotropin OI cycles.

Intervention(s): Patients were treated with recombinant FSH alone (group 1) or in conjunction with Ganirelix when the leading follicle was ≥13 mm (group 2) versus from the beginning of stimulation (group 3), followed by IUI.

Main outcome measure(s): Per cycle clinical pregnancy rate (CPR), live-birth rate (LBR), total gonadotropin dose, days of stimulation, serum LH and peak E2, and premature luteinization rate.

Result(s): Data are suggestive of improved CPR in group 2 versus group 1 (33% vs. 19%) and LBR (35% vs. 20%) but not significantly different. Premature luteinization was highest in group 1 (21% vs. 1.8% in group 2 and 2.1% in group 3). Group 3 had the highest cancellation rate and cost without improving CPR and LBR. No differences were noted in peak serum E2, total gonadotropin dose, or days of stimulation.

Conclusion(s): Adding Ganirelix in a flexible protocol to gonadotropin OI cycles in women with PCOS may be beneficial by decreasing premature luteinization.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Drug Therapy, Combination
  • Female
  • Follicle Stimulating Hormone / administration & dosage*
  • Gonadotropin-Releasing Hormone / administration & dosage
  • Gonadotropin-Releasing Hormone / analogs & derivatives*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors*
  • Gonadotropins / administration & dosage
  • Hormone Antagonists / administration & dosage
  • Humans
  • Infertility, Female / drug therapy*
  • Infertility, Female / physiopathology
  • Luteinizing Hormone / blood
  • Ovulation Induction / methods*
  • Polycystic Ovary Syndrome / drug therapy*
  • Polycystic Ovary Syndrome / physiopathology
  • Pregnancy
  • Pregnancy Rate
  • Prospective Studies
  • Recombinant Proteins / administration & dosage


  • Gonadotropins
  • Hormone Antagonists
  • Recombinant Proteins
  • Gonadotropin-Releasing Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone
  • ganirelix