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Chapter 14: Cetrorelix

  • Sebastian Findeklee
    Correspondence
    corresponding author: Sebastian Findeklee Saarland University Hospital, Department for Gynaecology, Obstetrics and Reproductive Medicine and Gyn Alliance Sankt Ingbert/Neunkirchen/Jena, Germany Kirrberger Straße 100, Building 9 D-66421 Homburg
    Affiliations
    Saarland University Hospital, Clinic for Gynaecology, Obstetrics and Reproductive Medicine, Kirrberger Straße 100, Building 9, D-66421 Homburg and Gyn Alliance Sankt Ingbert/Neunkirchen/Jena, Poststraße 37, D-66386 Sankt Ingbert, Stummstraße 2, D-07743 Jena
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  • Klaus Diedrich
    Affiliations
    University of Schleswig-Holstein, Department of Obstetrics and Gynaecology, Campus Lübeck, Germany
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Open AccessPublished:November 21, 2022DOI:https://doi.org/10.1016/j.xfre.2022.11.012
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      Abstract

      This book chapter presents the most important clinical aspects concerning the GnRH antagonist cetrorelix and its importance in reproductive medicine. After an overview about the historical milestones in the development and establishment of cetrorelix in the context of ovarian stimulation treatment, its dosage, effects and side effects are evaluated. The chapter terminates with a conclusion emphasizing the ease of use and the increase in patient safety due to a significantly reduced risk of ovarian hyperstimulation syndrome with cetrorelix compared with the agonist protocol.
      Cetrorelix is a decapeptide and belongs to the group of GnRH (gonadotropin releasing hormone) antagonists. Its main function is the inhibition of LH (luteinizing hormone) secretion from the anterior pituitary gland, thereby preventing ovulation and inhibiting the production of sex steroids. After initial applications in oncology, cetrorelix has gained importance in reproductive medicine as part of the short antagonist protocol for controlled ovarian stimulation. The great merit of GnRH antagonists is the almost 100% prevention of ovarian hyperstimulation syndrome. Overall, the GnRH antagonist cetrorelix, which is injected subcutaneously once or twice a day by the patient, is characterized by good efficacy and tolerability. However, an allergic local skin reaction with redness, swelling and pain can be observed occasionally in patients utilizing the drug. In conclusion, GnRH antagonists, such as cetrorelix, are currently the standard in IVF (in-vitro fertilization) and ICSI (intracytoplasmatic sperm injection) treatments.