More Indications for the Use of GnRH Antagonists

Abstract

Purpose: Due to their ability to effectively suppress the LH surge, the primary use of GnRH antagonists is to prevent premature luteinization and ovulation during ovarian stimulation. We describe two cases which represent new indications for the use of GnRH antagonist that may prevent distressing complications associated with infertility therapy. Methods: A 25-year-old anovulatory woman with PCOS who was treated with clomiphene citrate exhibited an excessive response. The second case involved a 45-year-old egg recipient who underwent hormonal preparation with estradiol valerate. At an early stage of treatment a dominant follicle developed that could result in undesired premature ovulation and cycle cancellation. A GnRH antagonist was administered in both cases. Results: In the first case OHSS was prevented, and a singleton pregnancy was achieved. In the second case, spontaneous ovulation was avoided and a singleton pregnancy was accomplished as well. Conclusions: GnRH antagonists can be used for the prevention of distressing complications of clomiphene citrate treatment and for the prevention of unwanted spontaneous ovulation during hormonal preparation in oocyte recipients.