GnRH Antagonist Therapy

  1. Nature of the Drug
    Antagon® (ganirelix acetate) and Cetrotide® (cetrorelix) are GnRH antagonists (hormonal drugs) which are currently approved for enhancing response to ovulation inducing drugs, and specifically to prevent premature ovulation.
  2. Risks and/or Side Effects
    • GnRH antagonists have not been shown to cause major side effects in humans so far. The drugs are known to act primarily by suppressing pituitary hormone levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH). Potential risks of therapy include :
      1. failure of the drug to produce the desired effect,
      2. discontinuation of menses,
      3. hot flashes, vaginal dryness, mood swings, headaches, and spotting, and
      4. localized skin reaction at injection site.
       
    • In rats, large doses of this drug have been shown to cause resorption of pregnancy. In humans when taken during pregnancy is associated with fetal death approximately 4% of the time. More commonly experienced side effects include abdominal pain (5%), headache (3%), ovarian hyperstimulation syndrome (2.4%), vaginal bleeding (1.8%), and nausea (1%)
     
  3. Potential Benefits
    Enhanced response to ovulation induction drugs
  4. Alternatives
    1. GnRH agonists
    2. Ovulation induction medications without GnRH antagonists or agonists
     

Dosages of medication are relative to the individual patient and purpose of the therapy and are evaluated on an ongoing basis.

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