Ovarian hyperstimulation, GnRH

Four synthetic decapeptides that function as competitive antagonists of GnRH receptors are available for clinical use. Ganirelix, cetrorelix, abarelix, and degarelix inhibit the secretion of FSH and LH in a dose-dependent manner. Ganirelix and cetrorelix are approved for use in controlled ovarian hyperstimulation procedures, whereas abarelix and degarelix are approved for men with advanced prostate cancer. 

Leuprolide Agonist of GnRH receptors Increased LH and FSH secretion with intermittent administration reduced LH and FSH secretion with prolonged continuous administration Ovarian suppression, controlled ovarian hyperstimulation, central precocious puberty advanced prostate cancer Administered IV, SC, IM or intranasally depot formulations are available Toxicity Headache, lightheadedness, nausea, injection site reactions t symptoms of hypogonadism with continuous treatment... 

In one case, a complex cyst, thought to be due to ovarian hyperstimulation, resolved after monthly administration of a depot gonadorelin (GnRH) receptor agonist without abandoning tamoxifen (72). One might expect some patients to react to tamoxifen with ovarian hyperstimulation, since another non-steroidal antiestrogen (that is clomiphene) is used for ovarian stimulation and also on occasion produces cysts. 

Jirecek S, Nagele F, Huber JC, Wenzl R. Ovarian hyperstimulation syndrome caused by GnRH-analogue treatment without gonadotropin therapy in a patient with polycystic ovarian syndrome. Acta Obstet Gynecol Scand 1998 77(9) 940-1. 

No side effects of treatment were reported by 13 women receiving treatment with the GnRH antagonist Cetrotide (2 X 250 pg SC doses) for early-onset ovarian hyperstimulation syndrome in a noru-andomised outpatient study [19 ]. 

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