Cetrotide for IVF: How and Why it’s Used
Cetrotide is a widely used medication in In Vitro Fertilization (IVF) and egg-freezing treatments to prevent premature ovulation and support multiple eggs in reaching full maturity before retrieval. This is crucial for the success of IVF therapy, as it can increase the chances of developing healthy embryos that can later be transferred.
This article will explore how Cetrotide works in the IVF process and what patients can expect when using this medication.
What is Cetrotide?
Cetrotide (cetrorelix) is a gonadotropin-releasing hormone (GnRH) antagonist that temporarily delays ovulation.
How Cetrotide Works
Cetrotide, like other GnRH (Gonadotropic-releasing hormone) antagonists, stops the hormone GnRH from binding with receptors in the brain. When allowed to bind, GnRH causes the pituitary gland to secrete luteinizing hormone (LH). By rapidly inhibiting the secretion of Luteinizing Hormone (LH), ovulation is delayed, and multiple eggs can continue to mature.
Ovulation will only occur when triggered by an hCG or Lupron trigger shot later in the IVF process.
How Cetrotide is Used with IVF
Follicles naturally develop at different rates, so it is essential to prevent the most mature egg from releasing before some of the less developed eggs are ready for retrieval.
By rapidly halting the natural secretion of LH in the body, Cetrotide helps to synchronize the development of multiple follicles to encourage similar growth patterns. This allows your fertility specialists to retrieve the eggs at the optimal time and maturity stage, ensuring that your treatment has the greatest chance for success.
Alternatives to Cetrotide: Other GnRH Antagonists
Cetrotide is the brand name of a common GnRH Antagonist. Ganarelix is another brand name GnRH antagonist made by a different pharmaceutical manufacturer. However, it functions in the same way and is often used instead of Cetrotide.
Advantages of Cetrotide and other GnRH Antagonists
Cetrotide has some distinct advantages over other drugs and is a treatment option for certain groups of women.
A 2023 chapter in Fertility and Sterility Reports concluded that the primary advantages of using Cetrotide include :
- A straightforward and patient-friendly approach
- Shorter stimulation duration: Unlike earlier drugs designed to prevent premature ovulation, Cetrotide avoids the “flare phase.” It begins suppressing hormone production in the pituitary gland almost immediately after administration. Consequently, it doesn’t need to be initiated well in advance of other fertility medications. Typically, Cetrotide is administered for less than a week, resulting in fewer doses required per treatment cycle.
- Reduced stimulation medication (gonadotropins) usage, which lowers medication costs.
- Significantly decreased risk of Ovarian Hyper Stimulation Syndrome (OHSS).
- Fewer hormonal issues such as ovarian cysts or hormonal withdrawal after retrieval.
- achieves comparable pregnancy rates to those using GnRH agonists.
A 2018 study found that women with PCOS who received GnRH antagonist treatment for three days at the start of their cycle experienced :
- fewer cases of OHSS
- had higher early pregnancy rates
- more mature eggs
- more fertilized eggs
- more embryos
- higher clinical pregnancy rates.
Cetrotide and IVF Success Rates
In evaluating success rates with IVF and the use of Cetrotide, we determine this based on overall pregnancy rates.
A 2023 article showed:
- Pregnancy rates of 39% with Cetrotide vs.34% without
- Miscarriage rates of 7% with Cetrotide vs. 10% without
- No cycle canceled with threat of early ovulation vs. 5% canceled without the use of Cetrotide
When is Cetrotide Administered?
Cetrotide typically starts around the 6th day of ovarian stimulation. However, this is not always the case, as the timing is determined by how the LH level is rising and the follicle development through the cycle.
How is Cetrotide Administered?
Cetrotide is injected subcutaneously (into the fat). The process is generally simple and can be done at home after proper instruction. CNY and Cetrotide both offer educational videos for administration on our respective websites.
The recommended injection site is usually a few inches below the belly button. Because this injection is required daily, most providers recommend alternating sides of the abdomen to avoid soreness.
Side Effects
Potential side effects of Cetrotide are usually mild, such as headaches, nausea, bruising at injection site, itching at injection site, or inflammation at the injection site.
These side effects, if present, typically resolve on their own. More serious side effects indicating an allergic reaction, such as hives, trouble breathing, or swelling of the tongue are very uncommon. However, it is suggested to seek immediate medical care if they occur.
Cetrotide with IVF: The Takeaway
Cetrotide is used during the stimulation phase of the IVF process to prevent premature ovulation for retrieval. This helps synchronize follicle development, increasing the chances of more mature eggs retrieved for successful fertilization and subsequent embryo development.
Compared to medications that delay ovulation via alternative mechanisms, Cetrotide (and other GnRH Antagonists) offers advantages like shorter stimulation, lower overall costs, and reduced risk for OHSS development, making it a patient-friendly choice.
Administered via simple injections, its side effects are usually mild and resolve on their own. With effective monitoring, Cetrotide (or other GnRH Antagonists) plays an important role in the success of IVF.
