# Buserelin vs. Cetrotide



## nippo

Hi There,

I am on a Cetrotide protocol at my NHS hospital with Menopur.

I was previously on Merional and cetrotide and did very well on it, this time on Menopur I produced half the number of eggs. I have now been given the choice of swapping Cetrotide for Buserelin and the only information that I have is that it is a different hormone for stopping ovulation...

I don't have enough information to really make a decision. I just want to know what the difference is between the way cetrotide and Bserelin work?

On Cetrotide I produced 4 eggs and all 4 fertilised - and we had 2 grade 1 embryos put back on day 3 if this helps shed light on things...


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## Mistletoe (Holly)

This is the way I understand it.
Buserelin is an agonist - which means it stimulates the release of all your FSH and LH by continually stimulating the pituitary until the hormones run out effectively. It can take 8 weeks for pituitary function to return after stopping. Initially you may get a flare of natural FSH as it is released - this can help in short protocol when you get a flare of hormones at the start of the cycle. In long protocol, complete control of the hormones is achieved way before the cycle starts by switching off the pituitary a week before the period so there is no release of FSH and LH at the start of the cycle that would normally happen and so the doctor has complete control of the amount of FSH given to the woman when she may be a good or over responder.
You will get menopausal symptoms with buserelin like hot flushes.

Cetrotide is an antagonist - which means it blocks the action of the hormone in the body which would naturally stimulate the pituitary to secrete LH. It can be given later on in the cycle towards the time an LH surge is getting near. You won't get hot flushes. Treatment duration is shorter.

I was trying to look at some papers last night to see what might be the difference in egg numbers etc. Looking briefly - you should discuss the doctor's reasoning with them in your case - it seems that there might be more follicles of the same size in patients treated with cetrotide, but there was no difference in egg numbers or pregnancy in the end. It might reduce the risk of ovarian hyperstimulation.


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## nippo

Seeing as I have a very high FSH and that I will never be an over-responder, maybe I should stick with the cetrotide...?


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## Mistletoe (Holly)

Best to discuss the pros and cons of each with your consultant . If you are doing short protocol the flare from day 2 buserelin might help? I don't know enough about all the clinical trials and consultant experience to advise. It is your fertility specialist's job to pick the best drug for your medical history.


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