This paper is only available as a PDF. To read, Please Download here.
Abstract
Ganirelix is a GnRH antagonist with high antagonistic activity that blocks the GnRH receptor by competitive binding. A daily dose of 0.25 mg ganirelix was selected following a Phase 2 study as it was the minimal, effective daily dose to prevent premature LH surges, and yielded the highest ongoing pregnancy rate per started cycle. Following subcutaneous administration, ganirelix is rapidly absorbed, reaching peak levels 1 to 2 hours (tmax) and has a high absolute bioavailability (>90%). Prospective, comparative studies have demonstrated the advantages of GnRH antagonist over long GnRH agonists treatment in assisted reproduction, including: (i) the immediate reversibility of drug effects; (ii) a requirement for less FSH; (iii) a shortened duration of stimulation; (iv) a reduced incidence of ovarian hyperstimulation syndrome (OHSS); and (v) reduced patient burden. Combined analyses concluded that in the general IVF population, there is a slightly lower ongoing pregnancy rate, but also a lower risk of OHSS that is largely eliminated when considering triggering with GnRH agonist instead of hCG. Regardless of all research, it is still not fully elucidated why the long GnRH agonist protocol has a trend for higher pregnancy rates following fresh transfer of the same number of good quality embryos.
Keywords
Article info
Publication history
Accepted:
February 20,
2023
Received in revised form:
February 10,
2023
Received:
October 4,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 The Author(s). Published by Elsevier Inc. on behalf of American Society for Reproductive Medicine.
User license
Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) | How you can reuse 
Elsevier's open access license policy
Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0)
Permitted
For non-commercial purposes:
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article (private use only, not for distribution)
- Reuse portions or extracts from the article in other works
Not Permitted
- Sell or re-use for commercial purposes
- Distribute translations or adaptations of the article
Elsevier's open access license policy
