In long or short protocols, the patients received controlled ovarian stimulation with recombinant follicle-stimulating hormone (FSH) (Puregon®; Organon, the Netherlands) and gonadotropin-releasing hormone agonists (Decapeptyl®; Ferring, Germany). FSH doses were changed according to the ovarian response, which was assessed using ultrasound and by evaluating estrogen and progesterone levels. Then, 5,000–10,000 units of human chorionic gonadotropin (Pregnyl®; Saint-Prex, Switzerland) were administered to induce oocyte maturation. At 36 h after induction, follicular aspiration was performed under ultrasound guidance.
Decapeptyl
Manufactured by Ferring
Sourced in Germany, Switzerland
Decapeptyl is a lab equipment product manufactured by Ferring. It is a synthetic peptide that functions as a gonadotropin-releasing hormone (GnRH) agonist.
Automatically generated - may contain errors
Lab products found in correlation
Gonal f, by Merck Group (21 mentions)
Cetrotide, by Merck Group (17 mentions)
Menopur, by Ferring (16 mentions)
Ovidrel, by Merck Group (12 mentions)
Ovitrelle, by Merck Group (6 mentions)
Puregon, by MSD (3 mentions)
Cetrorelix, by Merck Group (3 mentions)
Puregon, by Organon (2 mentions)
Triptorelin, by Ferring (2 mentions)
Menogon, by Ferring (2 mentions)
Diphereline, by Ipsen (2 mentions)
Human chorionic gonadotropin (hcg), by Merck Group (2 mentions)
Pregnyl, by Organon (2 mentions)
Pergoveris, by Merck Group (2 mentions)
Cetrorelix acetate, by Merck Group (1 mentions)
Orgalutran, by MSD (1 mentions)
G1 medium, by Vitrolife (1 mentions)
Repli g single cell kit, by Qiagen (1 mentions)
Rekovelle, by Ferring (1 mentions)
Crinone, by Merck Group (1 mentions)
57 protocols using decapeptyl
1
Controlled Ovarian Stimulation and Oocyte Retrieval
2
Dual Trigger Approach for Controlled Ovarian Stimulation
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Both gonadotropin-releasing hormone (GnRH) agonist (Lupron; Takeda Chemical Industries, Tokyo, Japan) and antagonist (cetrorelix acetate; Merck Serono, Darmstadt, Germany) protocols were used for controlled ovarian stimulation (COS). For ovarian stimulation, all patients received a recombinant follicle-stimulating hormone (FSH, Gonal-F; Merck Serono) from cycle day 3 until the diameter of the dominant follicle exceeded 18 mm, followed by a dual trigger, including 250 μg of human chorionic gonadotropin (hCG) (Ovidrel; EMD Serono, Rockland, MA, USA), and 0.2 mg of triptorelin (Decapeptyl; Ferring, Schleswig–Holstein, Germany) at 36 h before oocyte retrieval. Finally, COS procedures involving GnRH agonist and antagonist protocols, oocyte collection, and denudation were performed as previously described56 (link).
3
Controlled Ovarian Stimulation Protocol
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After a baseline pelvic ultrasound, controlled ovarian stimulation was commenced on the third day of the menstrual cycle for three consecutive days with a fixed starting dose of r-FSH (Gonal-F; Merck Serono Biopharma) of 450 IU for all subjects. The starting dose was chosen based on observations from previous studies [15 (link), 16 (link)] that demonstrated no added benefit to daily gonadotropin dosing above 450 IU. The daily r-FSH dose was then adjusted according to ovarian response. When at least one follicle reached 14 mm in diameter, GnRH antagonist (Cetrotide; Merck Serono Biopharma) was added to the stimulation protocol. When at least two leading follicles reached 18 mm in diameter, induction of final oocyte maturation was triggered either by 6500 IU of recombinant hCG (Ovidrel; Merck Serono Biopharma), or by a combination of 6500 IU of recombinant hCG and 0.2 mg of triptorelin (Decapeptyl; Ferring Pharmaceuticals). The choice of triggering method was based on the attending physicians’ discretion.
Oocyte retrievals were performed under transvaginal ultrasound guidance, 35 to 36 h post triggering. Standard insemination procedures were performed for all cases, with exceptions in cases with male factor, for which intracytoplasmic sperm injections (ICSI) were performed instead. All embryo transfers were performed on day-3 after oocyte retrieval.
Oocyte retrievals were performed under transvaginal ultrasound guidance, 35 to 36 h post triggering. Standard insemination procedures were performed for all cases, with exceptions in cases with male factor, for which intracytoplasmic sperm injections (ICSI) were performed instead. All embryo transfers were performed on day-3 after oocyte retrieval.
4
Natural Cycle Oocyte Retrieval Protocol
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In the natural cycle group, oocyte pick-up (OPU) was performed within a pure natural cycle that excluded any hormonal stimulation except for GnRH agonist (GnRHa) administration for ovulation induction. Ultrasound monitoring began on cycle day 7 until the dominant follicle presented. When the follicle reached a diameter of 13 mm or greater and the E2 exceeded 150 pg/ml, patients were monitored every day or every other day. When the dominant follicle reached 18 mm in diameter, in the absence of a LH rise, the final stage of oocyte maturation was induced around midnight with 100 μgof triptorelin (Decapeptyl, Ferring GmbH, Germany). A nonsteroidal anti-inflammatory drug, ibuprofen (0.6 g), was used on the trigger day and the following day.Transvaginal ultrasound-guided oocyte retrieval was scheduled 32-36 h later. For cases with a mature follicle and the occurrence of a spontaneous LH surge (LH >20 mIU/ml), GnRHa was not administered, and only ibuprofen was used. Oocyte retrieval was arranged 18-30 h later, according to the presumed stage of the spontaneous LH surge on the scheduled day [14 ].
5
GnRH Antagonist Stimulation Protocol
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Hormonal stimulation was performed in GnRH antagonist protocols with recombinant FSH (Puregon®, MSD; Gonal F®, MerckSerono) or human menopausal gonadotropin (Menogon® or Menopur®, Ferring). The starting dosage was chosen according to the results of the anti-Müllerian hormone and antral follicle count (14 (link)). Starting on day 5, patients received a daily dosage of 0.25 mg GnRH antagonist (Orgalutran®, MSD or Cetrotide®, MERCK) to prevent premature ovulation.
During the stimulation course, stimulation dosage was adapted to the individual patient’s response. GnRH agonist trigger for final oocyte maturation was used to avoid OHSS as the ultrasound showed >13 follicles with a size of ≥11 mm (13 (link)). Patients received 0.3 mg of Triptorelin (Decapeptyl®, Ferring) for final oocyte maturation, as soon as ≥3 follicles were ≥17 mm in diameter. OPU was performed 36 h later under mild sedation, aspirating all follicles of a size of ≥11 mm.
During the stimulation course, stimulation dosage was adapted to the individual patient’s response. GnRH agonist trigger for final oocyte maturation was used to avoid OHSS as the ultrasound showed >13 follicles with a size of ≥11 mm (13 (link)). Patients received 0.3 mg of Triptorelin (Decapeptyl®, Ferring) for final oocyte maturation, as soon as ≥3 follicles were ≥17 mm in diameter. OPU was performed 36 h later under mild sedation, aspirating all follicles of a size of ≥11 mm.
6
Controlled Ovarian Stimulation Protocol
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On day 5 of menstruation, females received desogestrel (0.15 mg) and ethinylestradiol (30 ug) tablets (Marvelon, Organon Pharmaceutical Co Ltd, the Netherlands; one tablet per day for 17 consecutive days). Then, triptorelin acetate (Decapeptyl, Ferring Pharmaceuticals) was used at a dose of 0.1 mg/day until pituitary downregulation was confirmed (no ovarian cysts > 8 mm; E2 < 50 pg/ml). Gonadotropin (Gn, Anhui Fengyuan Pharmaceutical Co., China) was used at an initiative dose ranging from 150–225 U. The late dose of Gn (Anhui Fengyuan Pharmaceutical Co., China) was adjusted according to the size, counts of follicles and hormone levels. When a follicle diameter = > 18 mm, or two follicles = > 17 mm, or 3 follicles = > 16 mm, human chorionic gonadotrophin (HCG, 5000–10,000 IU, Lizhu Pharmaceutical Trading Co., German) was administered for trigger ovulation.
7
Soft Progesterone and hMG for IVF
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The study group received soft progesterone capsules (brand name: Utrogestan, 100 mg, Laboratories Besins International, France) 100 mg and 150 IU of human menopausal gonadotropin (hMG) concomitantly from the menstrual cycle (MC) day 3 until the trigger day. The control group received the GnRH-ant protocol consisting of HMG 150 IU’s daily injection from MC 3 until the trigger day. GnRH-ant (Cetrotide, 0.25 mg, Merck-Serono) was started when at least one of the following criteria were met: LH >10 IU/L, the presence of at least one follicle with mean diameter >14 mm, or serum E2 level >600 pg/mL. According to follicular development, follicle size, and serum hormone levels, the dose of hMG remained fixed for the first 5–6 days of ovarian stimulation and could be adjusted after that. Once three dominant follicles reached 18mm in diameter, 0.1 mg GnRH-a (Decapeptyl®; Ferring Pharmaceuticals, Germany) was administered to induce oocyte maturation oocyte retrieval was performed 36–38 hours after trigger. In vitro fertilization, embryo culture, and assessment were carried out based on routine procedures in our clinic (5 (link)-9 (link)). Patients in both groups used a similar protocol for endometrial preparation, consisting of hormone replacement therapy or mild stimulation using Letrozole with or without hMG (10 (link)).
8
IVF with Single-Cell Biopsy
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This study was approved by the Medical Institutional Review Board of the International Peace Maternity and Child Health Hospital (IPMCH), Shanghai Jiao Tong University School of Medicine. The patient was treated with FSH (Gonal-F; Serono) after pituitary function was downregulated by treatment with a gonadotrophin-releasing hormone (GnRH) agonist (GnRH-a, Decapeptyl; Ferring). Follicular development was monitored by serial vaginal ultrasound imaging and measurement of serum E2 levels. Oocytes were retrieved at 36 h after human chorionic gonadotropin injection under ultrasound guidance and were subsequently fertilized by intracytoplasmic sperm injection (ICSI). The fertilized zygotes were cultured in G1 medium (Vitrolife, Sweden) at 37°C in a humidified atmosphere with 6% CO2. Single-cell biopsy was performed on day 3 after fertilization, and the DNA was amplified using the REPLI-g Single Cell Kit (Qiagen) according to the instructions. For each biopsied cell, a blank control was prepared from the final wash drop.
9
Ovarian Stimulation Protocols for IVF
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Women received routine ovarian stimulation protocols with either Menopur (hMG) or recombinant follicle-stimulating hormone (FSH; Bemfola, Gedeon Richter, Belgium, Menopur, Ferring, St. Prex, Switzerland, Gonal-F, Merck Serono, Switzerland or Rekovelle®, Ferring, St. Prex, Switzerland) with GnRH-agonist (Lucrin®, Abbott, Decapeptyl®, Ferring St. Prex, Switzerland) or GnRH-antagonist (Orgalutran®, MSD, Cetrotide®, Merck Serono, Fyremadel®, Ferring St. Prex, Switzerland) co-treatment protocol. A subcutaneous human recombinant chorionic gonadotropin (hCG) or GnRH-agonist (Ovitrelle®, Merck Serono, Switzerland, Pregnyl®, Organon, the Netherlands) injection was used for final follicular maturation. Oocytes were aspirated 35 h after ovulation induction and cultured in fertilization media (SAGE 1-step or G-TL Vitrolife).
10
GnRH Antagonist in Ovarian Stimulation
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Ovarian stimulation was started on day 2 or 3 of a spontaneous menstrual period. A total of 90.5% of patients received both recombinant FSH (Gonal-f®, Merck KGaA, Darmstadt, Germany; Elonva®, Merck Sharp & Dohme Limited, Hoddesdon, Hertfordshire, UK) and LH (Pergoveris®, Merck KGaA, Darmstadt, Germany; Menopur® Ferring Pharmaceuticals, Parsippany, NJ, USA); 9.5% of cycles received only recombinant FSH. We administered GnRH antagonist (0.25 mg) once a lead follicle of 14 mm mean diameter was observed by ultrasound imaging. Recombinant human chorionic gonadotropin (hCG) (Ovitrelle 250 μg, Merck) or GnRH agonist (Decapeptyl 0.2 mg, Ferring) was administered once three leading follicles reached ≥17 mm mean diameter; oocyte retrieval was performed 34–36 h later. Oocytes were fertilized with conventional IVF or ICSI.
The primary end-point of the study was the percentage of decline in serum LH levels following GnRH antagonist administration (calculated as the percent change in LH concentration from stimulation start to that observed before ovulation triggering). The secondary end-points were: examination of the response to GnRH antagonist administration in different subpopulations (ovulatory, anovulatory, and advanced age) and IVF outcome parameters. The study was approved by the local institutional review board.
The primary end-point of the study was the percentage of decline in serum LH levels following GnRH antagonist administration (calculated as the percent change in LH concentration from stimulation start to that observed before ovulation triggering). The secondary end-points were: examination of the response to GnRH antagonist administration in different subpopulations (ovulatory, anovulatory, and advanced age) and IVF outcome parameters. The study was approved by the local institutional review board.
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