Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study
IntroductionThis study aimed to compare the safety, efficacy, and clinical predictors of live birth outcomes between cetrorelix and ganirelix in GnRH antagonist protocols during controlled ovarian stimulation.MethodsIn this retrospective cohort study conducted at a reproductive medicine center (June...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Reproductive Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frph.2025.1492441/full |
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| author | Xinyue Peng Xingyu Lv Penghao Li Penghao Li Yingxing Li Yuling Hu Yi Zhang Yuan Li |
| author_facet | Xinyue Peng Xingyu Lv Penghao Li Penghao Li Yingxing Li Yuling Hu Yi Zhang Yuan Li |
| author_sort | Xinyue Peng |
| collection | DOAJ |
| description | IntroductionThis study aimed to compare the safety, efficacy, and clinical predictors of live birth outcomes between cetrorelix and ganirelix in GnRH antagonist protocols during controlled ovarian stimulation.MethodsIn this retrospective cohort study conducted at a reproductive medicine center (June 2019–June 2022), 2,365 patients receiving cetrorelix (Group A) and 7,059 patients receiving ganirelix (Group B) were analyzed after 1:3 propensity score matching. Outcomes included LH surge suppression, OHSS incidence, endometrial morphology, embryological parameters, and live birth rates. Multivariate logistic regression identified independent predictors of clinical success.ResultsCetrorelix demonstrated superior LH surge control, with lower incidences of LH ≥10 U/L (4.9% vs. 7.6%, p < 0.001) and LH ratio(trigger day LH Gn day LH) ≥2 (6.1% vs. 9.2%, p < 0.001). Endometrial receptivity was more favorable in Group A, with higher Type A (66.2% vs. 60.1%) and lower Type C morphology (5.3% vs. 6.3%, p < 0.001). Ganirelix showed a higher overall OHSS incidence (1.1% vs. 0.4%, p = 0.01). Live birth rates were comparable (47.2% vs. 49.4%, p = 0.074). Multivariate analysis revealed advanced female age (≥35 years) reduced success (aOR = 0.65, 95% CI 0.57–0.74, p < 0.001), while AMH ≥4 μg/L (aOR = 1.29, 95% CI 1.02–1.64, p = 0.034), and dual embryo transfer (aOR = 1.51, 95% CI 1.38–1.65, p < 0.001) improved outcomes.ConclusionCetrorelix and ganirelix demonstrate comparable live birth rates and embryo quality, yet exhibit distinct safety profiles. Cetrorelix provides superior LH surge suppression and reduced OHSS risk, making it preferable for high-risk patients, while ganirelix may serve cases requiring rapid LH control. Cetrorelix offering enhanced endometrial receptivity (66.2% Type A morphology) and safety advantages. These findings support cetrorelix's role in optimizing ART safety without compromising efficacy. |
| format | Article |
| id | doaj-art-dbaecff522174abfaa76ae1db79d9dca |
| institution | OA Journals |
| issn | 2673-3153 |
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| publishDate | 2025-04-01 |
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| series | Frontiers in Reproductive Health |
| spelling | doaj-art-dbaecff522174abfaa76ae1db79d9dca2025-08-20T02:28:02ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532025-04-01710.3389/frph.2025.14924411492441Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort studyXinyue Peng0Xingyu Lv1Penghao Li2Penghao Li3Yingxing Li4Yuling Hu5Yi Zhang6Yuan Li7Department of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaDepartment of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaDepartment of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaDepartment of Scientific Research and Education, Chengdu Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu, Sichuan, ChinaDepartment of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaDepartment of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaDepartment of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaDepartment of Reproductive Medicine, Sichuan Jinxin Xinan Women and Children's Hospital, Chengdu, Sichuan, ChinaIntroductionThis study aimed to compare the safety, efficacy, and clinical predictors of live birth outcomes between cetrorelix and ganirelix in GnRH antagonist protocols during controlled ovarian stimulation.MethodsIn this retrospective cohort study conducted at a reproductive medicine center (June 2019–June 2022), 2,365 patients receiving cetrorelix (Group A) and 7,059 patients receiving ganirelix (Group B) were analyzed after 1:3 propensity score matching. Outcomes included LH surge suppression, OHSS incidence, endometrial morphology, embryological parameters, and live birth rates. Multivariate logistic regression identified independent predictors of clinical success.ResultsCetrorelix demonstrated superior LH surge control, with lower incidences of LH ≥10 U/L (4.9% vs. 7.6%, p < 0.001) and LH ratio(trigger day LH Gn day LH) ≥2 (6.1% vs. 9.2%, p < 0.001). Endometrial receptivity was more favorable in Group A, with higher Type A (66.2% vs. 60.1%) and lower Type C morphology (5.3% vs. 6.3%, p < 0.001). Ganirelix showed a higher overall OHSS incidence (1.1% vs. 0.4%, p = 0.01). Live birth rates were comparable (47.2% vs. 49.4%, p = 0.074). Multivariate analysis revealed advanced female age (≥35 years) reduced success (aOR = 0.65, 95% CI 0.57–0.74, p < 0.001), while AMH ≥4 μg/L (aOR = 1.29, 95% CI 1.02–1.64, p = 0.034), and dual embryo transfer (aOR = 1.51, 95% CI 1.38–1.65, p < 0.001) improved outcomes.ConclusionCetrorelix and ganirelix demonstrate comparable live birth rates and embryo quality, yet exhibit distinct safety profiles. Cetrorelix provides superior LH surge suppression and reduced OHSS risk, making it preferable for high-risk patients, while ganirelix may serve cases requiring rapid LH control. Cetrorelix offering enhanced endometrial receptivity (66.2% Type A morphology) and safety advantages. These findings support cetrorelix's role in optimizing ART safety without compromising efficacy.https://www.frontiersin.org/articles/10.3389/frph.2025.1492441/fullgonadotropin-releasing hormone antagonistcetrorelixganirelixcontrolled ovarian stimulationlive birth rate |
| spellingShingle | Xinyue Peng Xingyu Lv Penghao Li Penghao Li Yingxing Li Yuling Hu Yi Zhang Yuan Li Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study Frontiers in Reproductive Health gonadotropin-releasing hormone antagonist cetrorelix ganirelix controlled ovarian stimulation live birth rate |
| title | Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study |
| title_full | Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study |
| title_fullStr | Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study |
| title_full_unstemmed | Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study |
| title_short | Comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in IVF/ICSI antagonist protocols: a retrospective cohort study |
| title_sort | comparison of pregnancy outcomes and safety between cetrorelix and ganirelix in ivf icsi antagonist protocols a retrospective cohort study |
| topic | gonadotropin-releasing hormone antagonist cetrorelix ganirelix controlled ovarian stimulation live birth rate |
| url | https://www.frontiersin.org/articles/10.3389/frph.2025.1492441/full |
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