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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Main Authors: Xinyue Peng, Xingyu Lv, Penghao Li, Yingxing Li, Yuling Hu, Yi Zhang, Yuan Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
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.
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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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