GnRH Agonists and Antagonists for NEET/AIIMS/USMLE/FMGE/PLAB
Video taken from the channel: Ranjan Kumar Patel
When should the antagonist be started in an IVF cycle?
Video taken from the channel: Fertility Courses
Scheduling GnRH antagonist cycles by Barış Ata
Video taken from the channel: Dr Barış Ata
GnRH agonist versus antagonist for ovarian stimulation: Pros & Cons by Peter Kovacs Part 1
Video taken from the channel: Dr. Gautam Allahbadia
What Is the Antagonist Protocol in IVF?
Video taken from the channel: fertilityauthority
GnRH Antagonist Protocols
Video taken from the channel: Amit Emcure
Infertility Treatments 2018
Video taken from the channel: Christopher Morosky
GnRH antagonists are injectable medications that are used during IVF treatment. They prevent premature ovulation, so your doctor will be able to retrieve the eggs from the ovaries before they are released and “lost.” Don’t confuse GnRH agonists (like Lupron) with GnRH antagonists. Specifically, they’re used as part of an in vitro fertilization (IVF) cycle.
What do GnRH antagonists do? GnRH antagonists are used in an IVF cycle to prevent ovulation. This allows your fertility doctor to control egg development and retrieve the eggs at the best time to ensure that your treatment is most likely to work. GnRH antagonists are used to trigger ovulation in assisted reproductive treatments such as AI, IVF, or ICSI. Its administration may cause the following effects: GnRH antagonists binds to the receptor, therefore GnRH cannot bind (competitive blockage).
Receptors are placed in the surface of the pituitary gonadotropic cells. GnRH antagonists (e.g. Ganirelix, Cetrotide, and Orgalutron) are currently used with many controlled ovarian stimulation (COS) protocols. The conventional approach is to administer 250mcg antagonist, daily starting from the 6 th -8th day after commencing ovarian stimulation with gonadotropins. GnRH Antagonists GnRH antagonists are synthetic analogs of GnRH that bind to the GnRH receptors in the pituitary, rapidly suppressing the secretion of gonadotropins.
Suppression is sustained throughout the time during which GnRH antagonists are administered and reversible within 1–2 weeks when treatment is. GnRH (Gonadotrophin Releasing Hormone) agonists are drugs that can help to stop premature ovulation and increase the chances of pregnancy during IVF and IUI treatments. If you ovulate early, we often get fewer eggs and the eggs tend to be lower quality and less useful for IVF. GnRH agonists work by essentially ‘shutting down’ the pituitary.
Gonadotropin-releasing hormone antagonists (GnRH antagonists) are a class of medications that antagonize the gonadotropin-releasing hormone receptor (GnRH receptor) and thus the action of gonadotropin-releasing hormone (GnRH). They are used in the treatment of prostate cancer, endometriosis, uterine fibroids, female infertility in assisted reproduction, and for other indications. It can be estimate, on a global scale that around 10%-12% of all IVF cycles are being performed with the use of GnRH antagonists. Interesting to find is that the 37% used daily injection with decreasing the dose by half when they start stimulation. The use of nasal spay is still very popular.
10% still issue the depot GnRH agonist preparations. GnRH agonists and antagonists are both synthetic analogs of the GnRH peptide hormone, and achieve castrate testosterone levels by shutting down the GnRH-mediated release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior. The majority of randomized clinical trials clearly shows that in “in Vitro” Fertilization and Embryo Transfer, the combination of exogenous Gonadotropin plus a Gonadotropin Releasing Hormone (GnRH) agonist, which is able to suppress pituitary FSH and LH secretion, is associated with increased pregnancy rate as compared with the use of gonadotropins without a GnRH agonist.
Protocols with GnRH antagonists.
List of related literature:
|from Yen & Jaffe’s Reproductive Endocrinology E-Book|
|from Berek & Novak’s Gynecology|
|from Textbook of Assisted Reproductive Techniques: Two Volume Set|
|from Creasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice E-Book|
|from Endocrinology: Adult and Pediatric E-Book|
|from Essential Obstetrics and Gynaecology E-Book|
|from Side Effects of Drugs Annual: A Worldwide Yearly Survey of New Data in Adverse Drug Reactions|
|from Avery’s Diseases of the Newborn E-Book|
|from Handbook of In Vitro Fertilization|
|from Comprehensive Gynecology E-Book|