Orgalutran for IVF: Purpose, Indications and Application

Orgalutran is a hormone-type drug whose active ingredient is ganirelix, a GnRH antagonist.

GnRH is the gonadotropin-releasing hormone, which is secreted by the hypothalamus in our brain to regulate a woman's menstrual cycle. Drugs analogous to this natural hormone are so expensive due to the difficulty of synthesizing GnRH exogenously.

This medicine is used in patients who are beginning assisted reproduction treatment. Specifically, Orgalutran is necessary for controlled ovarian stimulation, both for artificial insemination (AI) and in vitro fertilization (IVF).

The different sections of this article have been assembled into the following table of contents.

Composition and price

The presentation of Orgalutran consists of a package that can be of two different formats:

• Box with 1 pre-filled disposable syringe of a dose of 0.25 mg/0.5 ml. It costs around $69.00
• Box with 5 pre-filled disposable syringe of a dose of 0.25 mg/0.5 ml. This Orgalutran format costs about $199.99

Each syringe includes a needle protected by a natural rubber cap. The excipients of the aqueous solution are as follows: acetic acid, mannitol and water for injectable preparations.

Orgalutran for ovarian stimulation

Mechanism of action

The active principle of Orgalutran is ganirelix. It is an antagonist of GnRH, which is a hormone synthesized in the hypothalamus and exerts its effect on the pituitary gland to induce the secretion of the FSH and LH gonadotropins. This activates the woman's menstrual cycle and the ovarian follicles begin to develop, and then a mature egg is released.

In an assisted reproduction treatment, the aim is to prevent spontaneous ovulation from occurring and also to be able to control ovarian stimulation thanks to the administration of medication with exogenous hormones.

This is basically the function of ganirelix - the inactivation of the release of the endogenous hormones FSH and LH in order to prevent a premature ovulation of the follicles.

Indications and mode of administration

Orgalutran is indicated in women undergoing assisted reproduction treatment, especially IVF, to avoid the endogenous LH peak that occurs before ovulation and thus not lose the eggs before the follicular puncture.

This medicine is used in combination with other drugs whose function is to stimulate multiple follicular development such as Menopur, Gonal-f or Puregon.

For the correct application of Orgalutran, the following instructions for use can be taken into account:

• Subcutaneous injection, preferably in the thigh.
• The injection should be given once a day at the same time.
• Make sure to remove the air from the syringe before injecting.
• Vary the injection site every day.
• Do not inject if the solution is not clear or contains particles.
• Properly dispose of the syringe after use.

How is Orgalutran administered?

Treatment should begin 96-120 hours after the start of ovarian stimulation, that is, on the fifth or sixth day after injection of the gonadotropins. This treatment should continue until the day of ovulation induction, unless otherwise directed by the physician.

The main difference that Orgalutran has with other GnRH analogues is precisely the time of administration. Being an antagonist, Orgalutran stimulation consists of a short cycle.

Short cycle with Orgalutran

In an interview with Dr. Gorka Barrenetxea, the doctor tells us that:

Thanks to the use of GnRH antagonist drugs we have managed to shorten the treatment time.

In addition, the use of antagonists during stimulation allows ovulation induction with an agonist, which avoids the risk of ovarian hyperstimulation.

Contraindications and precautions

Orgalutran should not be used under any circumstances in the following cases:

• Hypersensitivity to the active ingredient and excipients
• Allergy to the GnRH hormone or any of its analogues.
• Women with moderate and severe alterations of the renal and hepatic function.
• Pregnant, breestfeeding or post-menopausal women.

There are other cases in which special attention should be paid before using Orgalutran as it could result in serious effects on the person. Therefore, it will be necessary to consult with your doctor if it is possible to administer this medication. Precautions should be taken in the following situations:

• Having an active allergy.
• Allergy to the latex contained in the needle cap of this drug.
• Risk of ovarian hyperstimulation syndrome.
• Incidence of congenital malformations.
• Risk of ectopic pregnancy with damaged fallopian tubes.
• The effectiveness of this medicine has not been proven in women weighing less than 50 kg or more than 90 kg.

In any case, it is necessary the medical prescription to get Orgalutran in the pharmacy, as well as to follow the instructions of the specialist for its correct administration.

Contraindications of Orgalutran

FAQs from users

How much does Orgalutran cost in the U.S?

Orgalutran injection of 0.25 mg/0.5ml range from $94.04 - $160.00 per pill or unit.

What is Orgalutran for?

Orgalutran is a “gonadotropin-releasing hormone antagonist” drug and acts against the action of gonadotropin-releasing hormone (GnRH) produced by our hypothalamus.

Orgalutran is used to prevent premature release of LH, which can cause spontaneous ovulation. It is used in IVF cycles to prevent ovulation because without its effect the risk of ovulation is high and it would produce a significant reduction in the number of eggs retrieved in a follicular puncture.

How many days must Orgalutran be injected?

The days of application of Orgalutran must be determined by the specialist responsible for the treatment. As it is a short cycle, this is usually about 5 or 6 days after having started with the ovarian stimulation. On the other hand, the time of day to inject Orgalutran is indifferent but it must always be done at the same time. For example, it is recommended to do it before lunch or dinner to have a guideline and remember at these times that you are at home of the application of the medication.

Is Orgalutran the same as Cetrotide?

Like Orgalutran, Cetrotide is also a GnRH antagonist and both drugs are used for the same purpose in a fertility treatment. The difference between the two drugs is that the active ingredient of Orgalutran is ganirelix, while that of Cetrotide is cetrorelix.

Does Orgalutran have to be in the fridge for preservation?

Orgalutran doesn't need to be kept in the fridge as it doesn't need to be cold. It is only necessary to have the precaution of having Orgalutran in a place protected from the light and inside the original package at room temperature.

Suggested for you

In addition to Orgalutran, there are other medications used in controlled ovarian stimulation. We recommend read more about this in the following article: Drugs used in IVF/ICSI.

References