cetrorelix and Hypogonadism

In this retrospective multicenter cohort study, women with congenital hypogonadotrophic hypogonadism (CHH) (n = 57) who underwent intra-cytoplasmic sperm injection in-between 2010-2014 were compared to age-matched controls with tubal factor infertility (n = 114) to assess ovarian stimulation cycle and pregnancy outcomes. Live birth rates (LBRs) per started cycle were 31.6 and 24.6% in CHH and controls groups, respectively (p = 0.36). Comparable success rates were also confirmed with the logistic regression analysis (OR: 1.44, 95% CI: 0.78-2.67, p = 0.24). Of the 57 women with CHH, 19 were stimulated with the gonadotropin-releasing hormone (GnRH) antagonist protocol, 13 with the long-GnRH-agonist protocol. Pituitary suppression (PS) was not employed in the remaining 25 cases. Compared to women with PS, women without PS had significantly higher embryo implantation rates (21.6 versus 52.6%, p = 0.03). Although there was a trend favoring no PS, LBRs (25.0 versus 40.0%, p = 0.26) per cycle were short of statistical significance. LBRs per cycle (57.1 versus 31.2%, p = 0.11) and miscarriage rates (11.1 versus 16.7%, p = 0.75) were similar between CHH women who were given estrogen + progesterone and progesterone alone to support the luteal phase. In conclusion, the optimal stimulation protocol appears to be exogenous gonadotropin stimulation alone, without PS, and progesterone-only luteal phase support in CHH patients.

Topics: Adult; Birth Rate; Cohort Studies; Embryo Transfer; Female; Fertility Agents, Female; Gonadotropin-Releasing Hormone; Humans; Hypogonadism; Infertility, Female; Live Birth; Ovulation Induction; Pregnancy; Sperm Injections, Intracytoplasmic; Treatment Outcome; Young Adult

Although the prostate of the cynomolgus monkey has been shown to be a particularly suitable model for the human, in vivo data on this organ are hardly available. We therefore applied transrectal ultrasonography to the investigation of the physiology and pathophysiology of monkey prostate under normogonadotropic and hypogonadal conditions in vivo.. Five intact and 7 long-term castrated monkeys were analysed repeatedly for assessment of the feasibility and variability of the method. In addition, cross-sectional evaluation was performed on 30 intact monkeys of various ages and on 7 long-term castrated monkeys. Finally, the vehicle (n = 5) controlled effects of androgen deprivation treatment with the GnRH antagonist cetrorelix (n = 4) for 25 days followed by semicastration at day 16 and full castration on day 25 were examined and prostate size was followed thereafter.. The monkey prostate shows an ellipsoid shape and ultrasonic appearance similar to the human prostate. Variability in 5 intact monkeys (mean +/- SE = 4.67 +/- 0.55 ml.) and 7 long-term castrated monkeys (0.88 +/- 0.08 ml.) was 8.5% and 5.6% respectively. In intact animals a linear correlation between age and prostate size/animal surface area was found (p = 0.0001). Prostate size in castrated animals was reduced (p < 0.001) compared to intact animals. In the experimental study, GnRH antagonist led to a significant reduction of prostate volume and testosterone levels compared to the vehicle group, while semicastration had no influence. Following removal of the second testis a further decrease of prostate volume was seen (p < 0.0001). When compared, castration and GnRH antagonist treatment induced a similar decrease of prostate volume over time.. Transrectal ultrasonography provides a feasible and reproducible approach for determination of prostate size in cynomolgus monkeys. Castration and GnRH antagonist treatment are equally effective in reducing prostate size.

Topics: Animals; Castration; Gonadotropin-Releasing Hormone; Hormone Antagonists; Hypogonadism; Macaca fascicularis; Male; Prostate; Ultrasonography