The reproductive outcomes as well as luteal phase gonadotropin and steroid profiles of this study have previously been published (22 (link)). In brief, hormonal stimulation was performed with GnRH antagonist co-treatment, using recombinant FSH (Puregon., MSD; Gonal F., Merck Serono) for ovarian stimulation. No LH activity was added. Once the leading follicle had reached a size of 13 mm, co-treatment with a GnRH antagonist (Cetrotide. 0.25 mg; Merck Serono) or (Orgalutran. 0.25 mg; MSD) was initiated and continued up until and including the day of induction of ovulation. Ovulation induction was performed with a single bolus of 0.2 mg triptorelin, s.c. (Decapeptyl. 0.1 mg, Ipsen, France) as soon as ≥3 follicles were ≥17 mm in diameter, followed by oocyte pick up (OPU) 36 h later. Retrieved oocytes were fertilized by either IVF or ICSI depending on sperm quality.
Orgalutran
Manufactured by Merck Group
Sourced in Germany, Spain, Canada, Netherlands
Orgalutran is a laboratory product manufactured by Merck Group. It is a synthetic hormone that acts as a gonadotropin-releasing hormone (GnRH) antagonist. Orgalutran's core function is to temporarily inhibit the release of luteinizing hormone and follicle-stimulating hormone from the pituitary gland.
Automatically generated - may contain errors
Lab products found in correlation
Cetrotide, by Merck Group (5 mentions)
Gonal f, by Merck Group (5 mentions)
Puregon, by MSD (4 mentions)
Menopur, by Ferring (3 mentions)
Ovitrelle, by Merck Group (2 mentions)
Decapeptyl, by Ipsen (2 mentions)
Puregon, by Merck Group (2 mentions)
Triptoreline, by Ipsen (1 mentions)
Menogon, by Ferring (1 mentions)
Decapeptyl, by Ferring (1 mentions)
Superfact, by Sanofi (1 mentions)
Gonapeptyl, by Ferring (1 mentions)
Procrin, by Abbott (1 mentions)
Ganirelix, by Merck Group (1 mentions)
11 protocols using orgalutran
1
GnRH Antagonist IVF/ICSI Protocol
2
Controlled Ovarian Stimulation Protocols
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Recombinant follicle-stimulating hormone (r-FSH) (Gonal-F; MerckSerono GmbH, Kiel, Germany or Puregon; MSD, Haarlem, the Netherlands) or human menopausal gonadotropin (Merional; IBSA, Lamone, Switzerland, or Menopur, Menogon; Ferring Company, Kiel, Germany) were used solely or in combination for controlled ovarian stimulation. Starting dose varied between 175 and 200 IU. Pituitary suppression was maintained by a GnRH antagonist (Orgalutran; MSD or Cetrotide; MerckSerono, addresses as above) or GnRH-agonist protocols, according to physician preference. Cycles were monitored by transvaginal ultrasound.
3
Controlled Ovarian Stimulation Protocol
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COS was initiated on day 2 or 3 of a spontaneous cycle. An initial dose of 225-300 IU recombinant FSH (rFSH; Gonal-F [Merck-Serono] or Puregon [MSD] ) and/or highly purified hMG (Menopur; Ferring Pharmaceuticals) was administered. From day 6 onward, the gonadotropin dose was estimated according to serum E 2 levels and a transvaginal ultrasound scan. When a leading follicle reached 13-14 mm, a GnRH antagonist (Cetrotide [Merck-Serono] or Orgalutran [MSD] ) was administered at 0.25 mg/d. Final oocyte maturation was triggered with the use of 250 mg recombinant hCG (rhCG; Ovitrelle [Merck-Serono]) as soon as the mean diameters of two follicles were R18 mm. In some cases, triggering was performed with a single dose of a GnRH agonist (0.1 mg triptorelin [Decapeptyl; Ipsen Pharma]). Oocyte retrieval was scheduled 36 hours after hCG injection.
4
Ovarian Stimulation and Oocyte Retrieval
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Stimulation, monitoring, and oocyte retrieval were performed using a GnRH antagonist (Orgalutran, Merck Sharp, and Dohme, The Netherlands) protocol (6 (link)). When the mean diameter of at least two leading follicles was 17 mm (determined using ultrasound), ovulation was triggered with a subcutaneous bolus of 250 μg r-hCG (Ovitrelle, Merck Serono, Germany), with oocyte retrieval 36 h later.
5
Uterine Agenesis Management: Comprehensive Evaluation and IVF Optimization
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The eight recipients had uterine agenesis as part of the Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHs). The patients underwent meticulous medical and psychological investigations, including imaging by abdominal/pelvic magnetic resonance imaging (MRI), serology (hepatitis A/B, human immunodeficiency virus, cytomegalovirus, Epstein-Barr virus, syphilis), clinical chemistry, human leukocyte antigen (HLA) typing with assays of donor-specific antibodies (DSAs), psychological tests, and interviews. Gynecological examination of recipients included an evaluation of the vagina and tests for chlamydia, gonorrhea, and high-risk human papillomavirus. In vitro fertilization (IVF) was performed to cryopreserve at least eight embryos. This necessitated 1–3 IVF cycles, using a protocol with a random and simultaneous start of purified human menopausal gonadotropin (hMG; Menopur®; Ferring, Sweden) and 0.25 mg of the gonadotropin-releasing hormone (GnRH) antagonist ganirelix (Orgalutran®; Merck, Germany).
6
Healthy Oocyte Donor Stimulation Protocol
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All oocyte donors were healthy women aged between 18 and 35 years. Controlled ovarian stimulation was performed using recombinant FSH or highly purified hMG (Gonal-F, Serono, Madrid, Spain; Menopur Ferring Pharmaceuticals, Madrid, Spain, respectively) and GnRH antagonist (Cetrotide, Merck Serono, Madrid, Spain; Orgalutran, Merck Sharp & Dohme, Madrid, Spain) for hypophysary suppression. Oocyte retrieval was performed 36 h after the administration of 0.2 or 0.3 mg of GnRH agonist (Triptoreline, Decapeptyl; Ipsen Pharma, Madrid, Spain).
7
GnRH-Antagonist IVF Stimulation Protocol
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Hormonal stimulation was performed in GnRH-antagonist protocols with recombinant FSH (Puregon, MSD; Gonal F, MerckSerono) or HMG (Human Menopausal Gonadotropin) (Menogon or Menopur, Ferring). The starting dosage was chosen according to the results of the Anti-Mullerian-Hormone (AMH) as well as the antral follicle count (AFC) [20 (link)]. Starting on day 5, patients received a daily dosage of 0.25 mg GnRH-antagonist (Orgalutran, MSD or Cetrotide, MERCK) to prevent early 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 ovarian hyperstimulation syndrome as the ultrasound showed > 13 follicles with a size of ≥ 11 mm, which was described previously as a risk factor for OHSS-development [21 (link)]. Patients received 0.3 mg of GnRH-agonist (Decapeptyl, Ferring) for final oocyte maturation, when > 3 follicles were ≥ 17mm in diameter. OPU was performed 36 h later under general anesthesia, 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 ovarian hyperstimulation syndrome as the ultrasound showed > 13 follicles with a size of ≥ 11 mm, which was described previously as a risk factor for OHSS-development [21 (link)]. Patients received 0.3 mg of GnRH-agonist (Decapeptyl, Ferring) for final oocyte maturation, when > 3 follicles were ≥ 17mm in diameter. OPU was performed 36 h later under general anesthesia, aspirating all follicles of a size of ≥11 mm.
8
Ovarian Stimulation Protocols for Poor Responders
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Ovarian stimulation was performed by means of one of the following protocols: microdose-flare protocol, fixed gonadotrophinreleasing hormone (GnRH) antagonist protocol and mid-luteal long GnRH agonist protocol. Briefly, ovarian stimulation was performed with gonadotrophins (Gonal-F, EMD-Serono Inc., Canada; Puregon, Merck Inc., Canada; Menopur, Ferring Pharmaceuticals Inc., Canada), ovulation was suppressed with GnRH antagonist (Cetrotide, EMD-Serono Inc.; Orgalutran, Merck Inc.) or GnRH agonist (Superfact, Sanofi-Aventis Inc., Canada). No standard stimulation protocol is used for patients with POR in our clinic; protocol and gonadotrophin dose were based on AFC, Day 3 FSH and the results of previous IVF cycles. Gonadotrophin dose was ≥300 IU FSH per day. After 5-7 days of stimulation, FSH dose was adjusted based on ultrasound scan and serum oestradiol level. The maximal dose of FSH was 600 IU. When ideally two follicles attained a mean diameter of 17 mm, 250 µg of human recombinant chorionic gonadotrophin was administered (Ovidrel, EMD-Serono Inc.). Oocyte retrieval by an ultrasound guided transvaginal approach was scheduled 36-38 h later.
9
Ovarian Stimulation Protocol for IVF
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The women received an initial dose of 300IU menotropin (Merional®) for four days, and on the fifth day of induction, the dose was reduced to 150IU/day. The first ultrasound to assess follicular development was performed between the fifth and the sixth day of induction. After identifying 02 follicles ≥14mm or 01 ≥16mm, 01 ampoule/day of ganirelix (Orgalutran®, Merck Sharp & Dohme B.V., Netherlands) was started up to 24 hours before the trigger. In the presence of two or more follicles with an average diameter of 18mm, a trigger with triptorelin (Gonapeptyl®, Ferring GmbH, Kiel, Germany) was prescribed and the egg collection was performed after 34-36 hours. After 2-4 hours of ovarian puncture, ICSI was performed, and the embryos were vitrified on the third day (D3) or on the blastocyst stage.
10
Letrozole and Ganirelix Acetate for IVF
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Following administration of dual trigger, a total of
122 patients were randomized into letrozole and ganirelix acetate groups of 61 each. Letrozole group received 2.5 mg of oral letrozole (Letoval, Sun Pharma
Laboratories Limited) twice daily. The ganirelix acetate group received ganirelix acetate 0.25 mg (Orgalutran, Merck Sharp, and Dohme) subcutaneously daily,
from the day of egg retrieval for the next seven days.
The computer randomization technique was used for
randomization.
122 patients were randomized into letrozole and ganirelix acetate groups of 61 each. Letrozole group received 2.5 mg of oral letrozole (Letoval, Sun Pharma
Laboratories Limited) twice daily. The ganirelix acetate group received ganirelix acetate 0.25 mg (Orgalutran, Merck Sharp, and Dohme) subcutaneously daily,
from the day of egg retrieval for the next seven days.
The computer randomization technique was used for
randomization.
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