A new analysis indicated that oral elagolix had comparable clinical outcomes to injectable medications for ovulation suppression during in vitro fertilization.
Research published in Fertility and Sterility Reports found no statistically significant differences in embryologic and clinical outcomes between elagolix and the injectable GnRH antagonists ganirelix/cetrotide (G/C) when used for pituitary suppression during controlled ovarian stimulation.
The study data showed that elagolix suppressed the hypothalamic-pituitary axis at a higher rate compared with injectable alternatives. Patients receiving elagolix at 50 mg every other day had a 42% reduction in luteinizing hormone levels postadministration compared with a 24% decrease with G/C.
Patients receiving elagolix at 200 mg twice daily had lower peak estradiol levels (7,505 pg/mL) compared with the G/C group (11,352 pg/mL, P = .03), with similar baseline characteristics, including ovarian reserve, age, and gonadotropin dosing.
The research measured endometrial receptivity, finding similar ongoing pregnancy, biochemical pregnancy, and miscarriage rates in fresh embryo transfer cycles between elagolix and injectable groups.
Researchers tested multiple dosing regimens, from 50 mg every other day to 200 mg twice daily. Oocyte maturation occurred using GnRH agonist alone, human chorionic gonadotropin (hCG) alone, or both in combination.
The study authors noted a limitation: the lack of power analysis, given the finding of no statistical significance in many outcome measures.
A multicenter, prospective, randomized, double-blind, placebo-controlled trial (PREGnant) is examining elagolix pretreatment in women with endometriosis prior to IVF. Additional research will investigate its role in preventing ovarian hyperstimulation syndrome.
Current in vitro fertilization (IVF) protocols require daily injections. The study examined whether oral medication could achieve similar results.
The researchers indicated that additional powered studies are needed to determine elagolix's role in IVF protocols. The author declared no competing interests.