Efficacy and safety of different cetrorelix doses in the luteal phase for preventing ovarian hyperstimulation syndrome: A cross-sectional study

Background: Ovarian hyperstimulation syndrome (OHSS) is a severe iatrogenic disorder resulting from controlled ovarian stimulation. The administration of a gonadotropin-releasing hormone antagonist (cetrorelix) during the luteal phase is a practical approach for preventing OHSS. Objective: This study aimed to evaluate the efficacy and safety of different cetrorelix regimens for preventing OHSS in high-risk groups. Materials and Methods: In this cross-sectional study, data of ۲۷۱ women with a high-risk profile for OHSS presented to the Infertility Center of Kosar hospital, Urmia, Iran from March ۲۰۲۳ and March ۲۰۲۵ and those who underwent intracytoplasmic sperm injection were extracted from their medical records. Participants were given prophylactic luteal-phase cetrorelix regimen of ۰.۵ mg twice daily (BID group, n = ۱۰۱), ۰.۵ mg ۳ times daily (TDS group, n = ۳۸), or ۰.۷۵ mg TDS group (n = ۱۰۲). After correcting for baseline characteristics, a logistic regression model determined independent hospitalization predictors. The primary outcomes measured in this study were the frequency and severity of OHSS and the rate of hospitalization due to OHSS. OHSS severity was graded according to standard classification, and hospitalization was defined as the need for inpatient management of OHSS. The study then compared these outcomes across the ۳ different cetrorelix dosing regimens. Results: OHSS frequency and severity decreased in a dose-dependent way, with no moderate or severe cases in the ۰.۷۵ mg TDS group (p < ۰.۰۰۱). Lower-dose groups had higher hospitalization rates than the ۰.۷۵ mg TDS reference group after adjusting for confounding variables. The likelihood was ۲۰ times higher for the ۰.۵ mg TDS group (adjusted odds ratio = ۱۹.۹۲, ۹۵% CI [۱.۹۹, ۱۹۹.۰۴]) and ۷۹ times higher for the ۰.۵ mg BID group (adjusted odds ratio = ۷۹.۲۹, ۹۵% CI [۹.۳۱, ۶۷۵.۴۳]). Conclusion: In individuals with elevated risk, ۰.۷۵ mg TDS luteal-phase cetrorelix more effectively decreases OHSS risk and reduces hospitalizations compared to lower dosages.

کلیدواژه ها:

Cetrorelix ، Gonadotropin-releasing hormone ، Ovarian hyperstimulation syndrome ، Sperm injections ، Intracytoplasmic ، Vascular endothelial growth factors. ، سترورلیکس ، هورمون آزادکننده گنادوتروپین ، سندرم تحریک بیش از حد تخمدان ، تزریق درون سیتوپلاسمی اسپرم ، فاکتورهای رشد اندوتلیال عروقی.