Xinyue Peng, Xingyu Lv, Penghao Li, Yingxing Li, Yuling Hu, Yi Zhang, Yuan Li
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引用次数: 0
Abstract
Introduction: This 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.
Methods: In 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.
Results: Cetrorelix 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.
Conclusion: Cetrorelix 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.
本研究旨在比较GnRH拮抗剂方案中cetrorelix和ganirelix在控制卵巢刺激期间的安全性、有效性和活产结局的临床预测因素。方法：在某生殖医学中心进行回顾性队列研究（2019年6月- 2022年6月），采用1:3倾向评分匹配方法对2,365例头孢瑞克（a组）患者和7,059例甘尼瑞克（B组）患者进行分析。结果包括LH激增抑制、OHSS发生率、子宫内膜形态、胚胎学参数和活产率。多因素logistic回归确定了临床成功的独立预测因素。结果：Cetrorelix具有较好的LH激增控制效果，LH≥10 U/L的发生率较低（4.9% vs. 7.6%, p p p p = 0.01）。活产率具有可比性（47.2% vs 49.4%, p = 0.074）。多因素分析显示，高龄女性（≥35岁）降低了双胚胎移植成功率（aOR = 0.65, 95% CI 0.57-0.74, p = 0.034）和双胚胎移植成功率（aOR = 1.51, 95% CI 1.38-1.65, p）。结论：Cetrorelix和ganirelix具有相当的活产率和胚胎质量，但具有不同的安全性。Cetrorelix提供卓越的黄体生成素激增抑制和降低OHSS风险，使其更适合高危患者，而ganirelix可用于需要快速控制黄体生成素的病例。Cetrorelix具有增强子宫内膜容受性（66.2%的A型形态）和安全性优势。这些发现支持cetrorelix在优化ART安全性而不影响疗效方面的作用。
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