Cetrotide (Cetrorelix)
GnRH antagonist for preventing premature ovulation in IVF treatment
Cetrotide (cetrorelix) is a prescription medication used during assisted reproduction techniques such as in vitro fertilization (IVF). It belongs to a class of medicines called GnRH antagonists, which work by blocking the body's natural hormone signals that trigger ovulation. By preventing premature egg release, Cetrotide allows fertility specialists to control the exact timing of egg retrieval, significantly improving the chances of a successful IVF cycle.
Quick Facts
Key Takeaways
- Cetrotide (cetrorelix) prevents premature ovulation during IVF by blocking GnRH receptors in the pituitary gland, suppressing the LH surge that would otherwise trigger early egg release.
- The standard dose is 0.25 mg injected subcutaneously once daily, typically starting on day 5 or 6 of ovarian stimulation and continuing until the trigger injection day.
- The most common side effects are mild injection site reactions (redness, itching, swelling); serious allergic reactions are uncommon but require immediate medical attention.
- Cetrotide must not be used during pregnancy, breastfeeding, or in patients with severe kidney disease; your first injection should be supervised by a healthcare professional.
- Store refrigerated at 2-8 degrees Celsius; unopened vials can be kept at room temperature (up to 30 degrees Celsius) for up to 3 months. Use the reconstituted solution immediately.
What Is Cetrotide and What Is It Used For?
Quick Answer: Cetrotide (cetrorelix) is a GnRH antagonist that prevents premature ovulation during IVF treatment by blocking the hormonal signals that trigger early egg release from the ovaries.
Cetrotide contains the active substance cetrorelix, a synthetic decapeptide that belongs to a group of medicines known as gonadotropin-releasing hormone (GnRH) antagonists. It is one of several medications used during assisted reproductive technology (ART) procedures, including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), to help women achieve pregnancy.
During a normal menstrual cycle, the brain releases GnRH, which stimulates the pituitary gland to produce luteinizing hormone (LH) and follicle-stimulating hormone (FSH). A sudden surge in LH triggers ovulation — the release of a mature egg from the ovary. In assisted reproduction, however, this natural LH surge can occur at an inconvenient time, causing premature ovulation before the fertility specialist can retrieve the eggs.
Cetrotide works by competitively binding to GnRH receptors on the gonadotroph cells in the anterior pituitary gland. This effectively blocks the action of the body's natural GnRH, preventing the premature LH surge and thereby preventing early ovulation. This mechanism gives the fertility team precise control over the timing of egg maturation and retrieval.
How Cetrotide Works: Mechanism of Action
The mechanism of action of cetrorelix involves a well-defined hormonal cascade. Under normal physiological conditions, the hypothalamus releases GnRH in a pulsatile fashion, which travels to the anterior pituitary gland and binds to specific GnRH receptors. This binding triggers the synthesis and release of the gonadotropins LH and FSH, which in turn act on the ovaries to promote follicular development and ultimately ovulation.
Cetrorelix acts as a competitive antagonist at the GnRH receptor. Unlike GnRH agonists, which initially stimulate and then desensitize the pituitary (a process known as downregulation), GnRH antagonists like cetrorelix produce an immediate and dose-dependent suppression of gonadotropin secretion. This rapid onset of action is one of the key clinical advantages of GnRH antagonist protocols compared with agonist protocols, as it reduces the duration of ovarian stimulation and the total amount of gonadotropins required.
Clinical studies have demonstrated that the GnRH antagonist protocol using cetrorelix is associated with comparable pregnancy rates to GnRH agonist long protocols, while offering the additional benefit of a significantly reduced risk of ovarian hyperstimulation syndrome (OHSS). A Cochrane systematic review (Al-Inany et al., 2016) confirmed that GnRH antagonist protocols are associated with a lower incidence of OHSS without compromising live birth rates.
Clinical Indications
Cetrotide is specifically indicated for the prevention of premature ovulation in patients undergoing controlled ovarian stimulation (COS) as part of an assisted reproduction programme. It is used in conjunction with exogenous gonadotropins (such as recombinant FSH or human menopausal gonadotropin) that are administered to stimulate the development of multiple ovarian follicles. The goal is to allow the follicles to mature to an optimal size before triggering final oocyte maturation with human chorionic gonadotropin (hCG) or a GnRH agonist trigger.
By preventing premature ovulation, Cetrotide ensures that the fertility specialist can plan the egg retrieval procedure at the most appropriate time, maximizing the number of mature oocytes available for fertilization and thereby improving the chances of a successful pregnancy.
What Should You Know Before Using Cetrotide?
Quick Answer: Cetrotide must not be used if you are pregnant, breastfeeding, have a severe kidney disease, or are allergic to cetrorelix or similar peptide hormones. Always inform your doctor about all medical conditions and medications before starting treatment.
Contraindications
Cetrotide is contraindicated in the following situations, and you must not use this medication if any of these conditions apply to you:
- Hypersensitivity: If you are allergic to cetrorelix, cetrorelix acetate, or any of the other ingredients in Cetrotide (including mannitol). Also contraindicated if you have a known allergy to other peptide hormone medications, as cross-reactivity may occur.
- Pregnancy and breastfeeding: Cetrotide must not be used during pregnancy or while breastfeeding. If you suspect you may be pregnant, inform your doctor immediately before using this medication.
- Severe renal impairment: Patients with severe kidney disease should not use Cetrotide, as the medication has not been adequately studied in this patient population and renal clearance may be significantly impaired.
If you are uncertain whether any of these conditions apply to you, consult your prescribing physician or fertility specialist before beginning treatment with Cetrotide.
Warnings and Precautions
Serious allergic reactions, including anaphylaxis, have been reported with Cetrotide. If you experience symptoms such as facial swelling, difficulty breathing, hives, rapid heartbeat, or dizziness after injection, stop using Cetrotide and seek immediate medical attention. Your first injection should always be administered under medical supervision.
Allergic reactions: Before starting Cetrotide, inform your doctor if you have any current allergies or a history of allergic reactions to medications. Anaphylactic reactions requiring emergency treatment have been reported, although they are uncommon (affecting up to 1 in 100 women). Symptoms of a serious allergic reaction include warmth and flushing of the skin, itching (often in the groin or armpits), hives, runny nose, rapid or irregular heartbeat, swelling of the tongue and throat, sneezing, wheezing or severe breathing difficulties, and dizziness.
Ovarian Hyperstimulation Syndrome (OHSS): While Cetrotide itself does not directly cause OHSS, it is used alongside gonadotropin medications that stimulate the ovaries. OHSS occurs when the ovarian follicles develop excessively and form large cysts. Mild symptoms include abdominal pain with nausea or vomiting and are common (up to 1 in 10 women). Severe OHSS, characterised by markedly enlarged ovaries, decreased urine output, weight gain, breathing difficulties, or fluid accumulation in the abdomen or chest, is less common (up to 1 in 100 women). Contact your doctor immediately if you experience any of these symptoms.
Multiple treatment cycles: Clinical experience with the use of Cetrotide across multiple IVF cycles is limited. If you require Cetrotide treatment for more than one cycle, your doctor will carefully weigh the benefits and risks specific to your situation before proceeding.
Liver disease: Inform your doctor if you have any liver condition before starting Cetrotide, as the medication has not been specifically studied in patients with hepatic impairment.
Kidney disease: If you have mild to moderate kidney disease, tell your doctor before using Cetrotide. Although severe kidney disease is a contraindication, patients with less severe renal impairment should also be monitored, as the medication has not been extensively studied in this population.
Pregnancy and Breastfeeding
Cetrotide is strictly contraindicated during pregnancy and breastfeeding. The medication is designed for use only during the ovarian stimulation phase of assisted reproduction, before pregnancy is established. If you discover that you are pregnant during treatment, discontinue Cetrotide immediately and inform your fertility specialist.
Animal studies have shown that cetrorelix may have effects on implantation and pregnancy maintenance, which is consistent with its pharmacological action of suppressing gonadotropin release. There are no adequate and well-controlled studies of Cetrotide in pregnant women, and the potential risk to the fetus is unknown.
Children and Adolescents
Cetrotide is not intended for use in children or adolescents. The medication is specifically indicated for adult women undergoing assisted reproductive procedures.
Driving and Using Machines
Cetrotide is not expected to affect your ability to drive vehicles or operate machinery. However, as with any injectable medication, individual responses may vary. If you experience any unusual symptoms such as dizziness after injection, avoid driving until the symptoms resolve.
How Does Cetrotide Interact with Other Drugs?
Quick Answer: Cetrotide is primarily used alongside other fertility medications (gonadotropins and hCG). Inform your doctor about all medications, supplements, and herbal products you are taking, as interactions with some medications may alter the effectiveness of your fertility treatment.
Although specific drug interaction studies with cetrorelix are limited, the pharmacological profile of GnRH antagonists suggests potential interactions with medications that affect the hypothalamic-pituitary-gonadal (HPG) axis. It is essential to inform your fertility specialist about all medications you are currently taking, have recently taken, or might take during your treatment cycle.
Medications Used Together in IVF Protocols
Cetrotide is routinely used in combination with several other medications as part of a controlled ovarian stimulation protocol. These are not adverse interactions but rather intentional co-administrations that require careful timing and dose coordination:
| Medication | Type | Clinical Significance |
|---|---|---|
| Gonadotropins (FSH, hMG) | Co-administered | Used together to stimulate follicular development; dosing must be coordinated by fertility specialist |
| hCG (Ovitrelle, Pregnyl) | Co-administered | Used to trigger final oocyte maturation; timing relative to last Cetrotide dose is critical |
| Progesterone | Sequential use | Started after egg retrieval for luteal phase support; no direct interaction with cetrorelix |
| GnRH agonists (leuprolide) | Potential interaction | Should generally not be combined with GnRH antagonists; may be used as trigger in specific protocols |
| Histamine-releasing medications | Caution advised | May theoretically increase risk of allergic reactions; inform your doctor if taking such medications |
Other Considerations
While no formal drug interaction studies have been conducted with cetrorelix and commonly prescribed non-fertility medications, patients should be aware of the following considerations:
- Hormonal contraceptives: Oral contraceptive pills are sometimes used for cycle scheduling before starting ovarian stimulation. They are typically discontinued before gonadotropin administration begins, and there is no clinically relevant interaction with Cetrotide when protocols are followed correctly.
- Herbal supplements: Some herbal products, particularly those with phytoestrogenic properties (such as black cohosh, red clover, or soy isoflavones), may theoretically affect the HPG axis. Inform your fertility specialist about all supplements you are taking.
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) are sometimes avoided during IVF cycles due to their potential effects on ovulation and implantation, rather than a direct interaction with cetrorelix.
Always provide your fertility specialist with a complete list of all medications, vitamins, and supplements you are taking before starting your IVF cycle. This includes over-the-counter medications, herbal remedies, and dietary supplements.
What Is the Correct Dosage of Cetrotide?
Quick Answer: The standard dose is one subcutaneous injection of Cetrotide 0.25 mg once daily, typically starting on day 5 or 6 of ovarian stimulation. Inject at the same time each day, with approximately 24 hours between doses, and continue until the day of the ovulation trigger.
Always use Cetrotide exactly as your fertility specialist has prescribed. The dosage, timing, and duration of treatment are carefully tailored to your individual response to ovarian stimulation, as monitored by ultrasound scans and blood hormone levels.
Adults
Standard Dosing Protocol (0.25 mg daily)
Dose: 0.25 mg (one vial) injected subcutaneously once daily
Injection site: Lower abdomen, rotating sites daily, at least 5 cm from the navel
Timing: At approximately the same time each day, with 24 hours between doses
Morning injection protocol: If you choose to inject in the morning, begin your Cetrotide injections on day 5 or 6 of ovarian stimulation (your doctor will determine the exact start day based on your ovarian response). Continue daily injections, including the morning of the trigger injection day (the day your doctor administers hCG or a GnRH agonist to trigger final egg maturation).
Evening injection protocol: If you choose to inject in the evening, begin your Cetrotide injections on day 5 of ovarian stimulation. Continue daily injections until the evening before the trigger injection.
| Parameter | Morning Protocol | Evening Protocol |
|---|---|---|
| Start day | Day 5 or 6 of stimulation | Day 5 of stimulation |
| Dose | 0.25 mg once daily | 0.25 mg once daily |
| Last dose | Morning of trigger day | Evening before trigger day |
| Typical duration | 4–5 days | 4–5 days |
Your fertility specialist will monitor your ovarian response using transvaginal ultrasound and blood tests (measuring estradiol and LH levels). The start day of Cetrotide may be adjusted based on your follicular development. Some protocols use a flexible start approach, initiating the GnRH antagonist when the leading follicle reaches 14 mm in diameter or when estradiol levels exceed a specific threshold.
Children
Cetrotide is not indicated for use in children or adolescents. There are no paediatric dosing recommendations.
Elderly
Cetrotide is used exclusively in women of reproductive age undergoing fertility treatment. There are no geriatric dosing recommendations, as the medication is not indicated for use in post-menopausal women.
Missed Dose
If you forget to take a dose of Cetrotide, inject it as soon as you remember and contact your fertility specialist for further guidance. Do not inject a double dose to compensate for a missed one. A missed dose could allow a premature LH surge, potentially compromising the timing of your egg retrieval. Your doctor may need to adjust your treatment plan accordingly.
Overdose
If you accidentally inject more Cetrotide than prescribed, adverse effects beyond the expected pharmacological action are not anticipated. The duration of the medication's effect will simply be prolonged. In most cases, no special measures are required. However, you should inform your fertility specialist so that your treatment can be monitored and adjusted if necessary. There is no specific antidote for cetrorelix overdose.
How to Prepare and Inject Cetrotide
Cetrotide is supplied as a powder that must be reconstituted (mixed) with sterile water before injection. Each pack contains a vial of powder, a pre-filled syringe of sterile water, a yellow-labelled needle (for reconstitution), and a grey-labelled needle (for injection). Follow these steps carefully:
- Prepare: Remove the vial from the refrigerator approximately 30 minutes before use to allow it to reach room temperature. Wash your hands thoroughly and lay out all components on a clean surface.
- Reconstitute: Remove the vial cap and wipe the rubber stopper with an alcohol swab. Attach the yellow-labelled needle to the pre-filled syringe. Insert the needle through the centre of the rubber stopper and slowly inject the water into the vial. Gently swirl (do not shake) until the powder is completely dissolved and the solution is clear.
- Draw up: With the syringe still in the vial, turn the vial upside down and carefully draw all the solution into the syringe. If the plunger is accidentally pulled out completely, discard the dose and start again with a new vial.
- Prepare for injection: Replace the yellow needle cap, remove the yellow needle, and attach the grey-labelled needle. Hold the syringe with the needle pointing upward, tap to move air bubbles to the top, and gently push the plunger to expel the air.
- Inject: Choose an injection site on the lower abdomen, at least 5 cm from the navel, using a different location each day. Clean the area with an alcohol swab. Pinch the skin gently, insert the grey needle at approximately a 45-degree angle, and slowly inject the solution. If blood appears when you pull back the plunger, withdraw the needle, discard the medication, and prepare a new dose.
- Dispose: Replace the needle cap and dispose of all needles, the vial, and the syringe safely in a sharps container. Each needle, vial, and syringe is for single use only.
Your first injection of Cetrotide should always be administered under the supervision of your doctor or nurse. They will show you the correct preparation and injection technique and inform you about signs of allergic reactions that require immediate medical attention. Subsequent injections may be self-administered if your healthcare provider confirms it is safe to do so.
What Are the Side Effects of Cetrotide?
Quick Answer: The most common side effects are mild injection site reactions (redness, itching, swelling). Uncommon side effects include nausea and headache. Serious allergic reactions are rare but require immediate medical attention. OHSS can occur as a result of the overall stimulation treatment.
Like all medicines, Cetrotide can cause side effects, although not everyone experiences them. The side effects listed below are categorised according to their frequency of occurrence based on clinical trial data and post-marketing surveillance reports. Most side effects associated with Cetrotide are mild and transient, particularly those at the injection site.
Common Side Effects
May affect up to 1 in 10 women
- Mild and temporary injection site reactions (redness, itching, swelling at the injection site)
- Ovarian hyperstimulation syndrome (OHSS) — mild form with abdominal discomfort, nausea, or bloating (related to overall stimulation treatment)
Uncommon Side Effects
May affect up to 1 in 100 women
- Nausea (feeling sick)
- Headache
- Severe OHSS with markedly enlarged ovaries, decreased urine output, weight gain, breathing difficulties, or fluid accumulation in the abdomen or chest
- Allergic reactions including warmth and flushing, itching (often in the groin or armpits), hives, runny nose, rapid or irregular heartbeat, swelling of tongue and throat, sneezing, wheezing, or severe breathing difficulties, dizziness
Allergic Reactions: When to Seek Emergency Help
Although uncommon, serious allergic reactions (including anaphylaxis) have been reported with Cetrotide. These reactions can be life-threatening and require immediate medical intervention. If you experience any of the following symptoms after injecting Cetrotide, stop using the medication and seek emergency medical help immediately:
- Difficulty breathing, wheezing, or severe shortness of breath
- Swelling of the face, lips, tongue, or throat
- Widespread hives or severe skin rash
- Rapid or irregular heartbeat
- Severe dizziness or feeling faint
- Feeling of impending doom
Because of the risk of allergic reactions, your healthcare provider should supervise your first injection and you should be informed about the symptoms that require emergency treatment before self-administering subsequent doses at home.
Ovarian Hyperstimulation Syndrome (OHSS)
OHSS is a potentially serious complication that can occur as a result of the gonadotropin medications used alongside Cetrotide to stimulate the ovaries. It is important to understand that OHSS is not caused by Cetrotide itself but by the overall ovarian stimulation treatment. Interestingly, GnRH antagonist protocols (which include Cetrotide) have been associated with a lower incidence of severe OHSS compared to GnRH agonist protocols, particularly when a GnRH agonist trigger is used instead of hCG.
Early symptoms of OHSS include abdominal pain, bloating, nausea, vomiting, and diarrhoea. In severe cases, the ovaries become markedly enlarged, and fluid can accumulate in the abdominal cavity (ascites) or around the lungs (pleural effusion). Other severe symptoms include rapid weight gain, decreased urine output, blood clot formation, and breathing difficulties. If you experience any of these symptoms, contact your fertility clinic immediately.
Reporting Side Effects
Reporting suspected side effects after a medicine has been authorised is important, as it allows ongoing monitoring of the medicine's benefit-risk balance. Healthcare professionals and patients are encouraged to report any suspected adverse reactions to their national pharmacovigilance authority, such as the EMA in Europe, the FDA MedWatch programme in the United States, or the MHRA Yellow Card Scheme in the United Kingdom.
How Should You Store Cetrotide?
Quick Answer: Store Cetrotide in the refrigerator at 2–8°C. Do not freeze. Unopened vials may be stored at room temperature (up to 30°C) for up to 3 months. Use the reconstituted solution immediately after preparation.
Proper storage of Cetrotide is essential to maintain the medication's potency and safety. Incorrect storage conditions can compromise the stability of the cetrorelix powder, potentially reducing its effectiveness or causing degradation products that may be harmful.
- Refrigerated storage: Store in a refrigerator at 2–8°C (36–46°F). Keep in the original packaging to protect from light.
- Do not freeze: Do not place the vials in the freezer or directly adjacent to a freezer compartment or cooling element.
- Room temperature storage: Unopened vials may be stored at room temperature (up to 30°C / 86°F) for a maximum of 3 months, provided they remain in the original packaging.
- After reconstitution: Once the powder has been dissolved in the sterile water, the solution must be used immediately. Do not store the reconstituted solution.
- Visual inspection: Before use, check that the white powder in the vial has not changed in appearance. After reconstitution, verify that the solution is clear and colourless and free of visible particles. Do not use if the solution is cloudy, discoloured, or contains particles.
- Expiry date: Do not use Cetrotide after the expiry date printed on the carton, vial, and pre-filled syringe. The expiry date refers to the last day of the stated month.
- Keep out of reach of children: Store all medicines where children cannot access them.
- Disposal: Do not dispose of medicines via household waste or wastewater. Return unused medications to your pharmacy for proper disposal to protect the environment.
What Does Cetrotide Contain?
Quick Answer: Each Cetrotide vial contains 0.25 mg of cetrorelix (as acetate) and mannitol as an excipient. The solvent is sterile water for injections provided in a pre-filled syringe.
Active Ingredient
The active substance in Cetrotide is cetrorelix, present as cetrorelix acetate. Each vial contains 0.25 mg of cetrorelix. Cetrorelix is a synthetic decapeptide with GnRH antagonist properties. Its chemical structure is based on natural GnRH but with specific amino acid substitutions that confer antagonist activity and improved metabolic stability.
Inactive Ingredients (Excipients)
The excipients in Cetrotide are minimal, reflecting the simplicity of the formulation:
- In the powder: Mannitol (a sugar alcohol used as a bulking agent and stabiliser to maintain the integrity of the lyophilised powder)
- In the solvent: Water for injections (sterile water provided in a 1 mL pre-filled syringe)
Appearance and Pack Sizes
Cetrotide is presented as a white lyophilised (freeze-dried) powder in a glass vial sealed with a rubber stopper. The sterile water solvent is a clear, colourless solution contained in a pre-filled syringe. The medication is available in packs containing either 1 vial with 1 pre-filled syringe or 7 vials with 7 pre-filled syringes. Not all pack sizes may be marketed in every country.
Each pack also includes two needles per vial: a yellow-labelled needle for reconstitution (injecting the water into the vial and drawing up the solution) and a grey-labelled needle for subcutaneous injection into the abdomen.
Frequently Asked Questions About Cetrotide
Cetrotide (cetrorelix) is used during assisted reproduction techniques such as IVF (in vitro fertilization) and ICSI to prevent premature ovulation. It blocks the body's natural GnRH receptors, stopping the LH surge that would otherwise cause eggs to be released before the fertility specialist can retrieve them. This precise timing control is essential for maximizing the chances of successful egg collection and subsequent embryo transfer.
Cetrotide is injected subcutaneously (just under the skin) in the lower abdomen. The powder must first be reconstituted by dissolving it in the provided sterile water using the yellow-labelled needle. After the solution is clear, draw it into the syringe, switch to the grey-labelled injection needle, remove air bubbles, and inject at a 45-degree angle. Rotate injection sites daily to minimize skin irritation. Your healthcare provider should demonstrate the technique before your first self-injection.
The most common side effects are mild and temporary injection site reactions, including redness, itching, and swelling at the injection site. These are experienced by up to 1 in 10 women and typically resolve on their own. Uncommon side effects (up to 1 in 100 women) include nausea and headache. Serious allergic reactions are rare but can occur and require immediate medical attention.
Cetrotide 0.25 mg is typically started on day 5 or 6 of ovarian stimulation. The exact start day is determined by your fertility specialist based on your ovarian response, as assessed by ultrasound and blood tests. Some clinics use a "flexible" protocol where Cetrotide is started when the leading follicle reaches approximately 14 mm in diameter. The medication is then continued daily until the trigger injection for final egg maturation.
Cetrotide should be stored in the refrigerator at 2–8°C (36–46°F) in its original packaging to protect from light. Do not freeze. If needed, unopened vials may be stored at room temperature (up to 30°C / 86°F) for up to 3 months. Once reconstituted (mixed with the sterile water), the solution must be used immediately — do not store the prepared injection for later use.
Cetrotide itself does not directly cause OHSS. However, it is used alongside gonadotropin medications that stimulate the ovaries, and OHSS can occur as a complication of the overall stimulation treatment. Importantly, GnRH antagonist protocols (using Cetrotide) are associated with a lower risk of severe OHSS compared to GnRH agonist protocols. Symptoms of OHSS include abdominal pain, bloating, nausea, and in severe cases, fluid accumulation and breathing difficulties. Contact your clinic immediately if you experience these symptoms.
References
- European Medicines Agency (EMA). Cetrotide — Summary of Product Characteristics (SmPC). Last updated 2025. Available at: https://www.ema.europa.eu/en/medicines/human/EPAR/cetrotide
- Al-Inany HG, Youssef MA, Ayeleke RO, et al. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology. Cochrane Database of Systematic Reviews. 2016;4:CD001750. doi: 10.1002/14651858.CD001750.pub4
- ESHRE (European Society of Human Reproduction and Embryology). ESHRE Guideline on Ovarian Stimulation for IVF/ICSI. Human Reproduction Open. 2020. doi: 10.1093/hropen/hoaa009
- Huirne JA, Lambalk CB. Gonadotropin-releasing-hormone-receptor antagonists. The Lancet. 2001;358(9295):1793-1803. doi: 10.1016/S0140-6736(01)06797-6
- Devroey P, Aboulghar M, Garcia-Velasco J, et al. Improving the patient's experience of IVF/ICSI: a proposal for an ovarian stimulation protocol with GnRH antagonist co-treatment. Human Reproduction. 2009;24(4):764-774. doi: 10.1093/humrep/den468
- World Health Organization (WHO). WHO Model List of Essential Medicines — 23rd List. 2023. Available at: https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2023.02
- U.S. Food and Drug Administration (FDA). Cetrotide (cetrorelix acetate for injection) — Prescribing Information. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021197s012lbl.pdf
- Kolibianakis EM, Collins J, Tarlatzis BC, et al. Among patients treated for IVF with gonadotrophins and GnRH analogues, is the probability of live birth dependent on the type of analogue used? A systematic review and meta-analysis. Human Reproduction Update. 2006;12(6):651-671. doi: 10.1093/humupd/dml038
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