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Oral GnRH antagonists for ovulation suppression during ovarian stimulation protocols: systemic review and

Nadav Cohen1,2,3, Ariel Zilbelicht4,5, Chen Nahshon4,5

  • 1Division Reproductive Endocrinology, Lady Davis Carmel Medical Center, Haifa, Israel. nadavco@clalit.org.il.

Journal of Assisted Reproduction and Genetics
|May 6, 2025
PubMed
Abstract

Insights

Oral gonadotropin-releasing hormone (GnRH) antagonists show potential benefits in IVF infertility treatments. However, further research is needed to confirm their effectiveness and safety in clinical practice.

Area of Science:

  • Reproductive Endocrinology
  • In Vitro Fertilization (IVF)

Background:

  • The clinical impact of oral gonadotropin-releasing hormone (GnRH) antagonists on in vitro fertilization (IVF) outcomes requires further clarification.
  • GnRH antagonists are utilized in controlled ovarian stimulation protocols to prevent premature luteinizing hormone surges.

Purpose of the Study:

  • To systematically review and meta-analyze the impact of oral GnRH antagonists on IVF treatment outcomes.
  • To assess the efficacy and safety of oral GnRH antagonists compared to injectable GnRH antagonists in IVF cycles.

Main Methods:

  • A comprehensive electronic literature search was conducted across major databases (MEDLINE, PubMed, Embase, Web of Science, Cochrane Library) up to December 16, 2024.
  • Included studies were experimental and non-experimental, evaluating oral GnRH antagonists in controlled ovarian stimulation.
  • Primary outcomes included cycle cancellation rate and the mean number of mature oocytes retrieved.

Main Results:

  • Four studies involving 813 patients were included in the meta-analysis.
  • No statistically significant differences were observed in cycle cancellation rates, oocyte yield, fertilization, or blastulation rates between oral and injectable GnRH antagonists.
  • The overall quality of the evidence was assessed as moderate using GRADE criteria.

Conclusions:

  • This systematic review and meta-analysis is the first to examine oral GnRH antagonists for ovulation suppression in IVF.
  • Findings suggest potential benefits of oral GnRH antagonists in infertility treatments.
  • Further clinical validation is necessary to establish the definitive effectiveness and safety of oral GnRH antagonists.
Keywords:
ElagolixMeta-analysisOral GnRHOvulation suppressionRelugolix

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