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ORIGINAL RESEARCH article
Front. Reprod. Health
Sec. Assisted Reproduction
Volume 7 - 2025 | doi: 10.3389/frph.2025.1492441
This article is part of the Research Topic Highlights in Assisted Reproduction 2023/24 View all 4 articles
Comparison of Pregnancy Outcomes and Safety Between Cetrorelix and Ganirelix in IVF/ICSI Antagonist Protocols: A Retrospective Cohort Study
Provisionally accepted- 1 Jinxin Xinan Women's and Children's Hospital, Chengdu, Sichuan, China
- 2 Jinxin Research Institute for Reproductive Medicine and Genetics, Chengdu, Sichuan Province, China
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.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.
Keywords: Gonadotropin-releasing hormone antagonist, Cetrorelix, Ganirelix, Controlled ovarian stimulation, live birth rate
Received: 06 Sep 2024; Accepted: 21 Mar 2025.
Copyright: © 2025 Peng, Lv, Li, Li, Hu, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xingyu Lv, Jinxin Xinan Women's and Children's Hospital, Chengdu, Sichuan, China
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