Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study.

Abstract

PURPOSE:

Embryological and clinical efficacy of gonadotropin-releasing hormone (GnRH) antagonist and agonist stimulation protocols in non-obese women with polycystic ovarian syndrome (PCOS) were compared.

METHODS:

A prospective randomized study.

SETTING:

Medical University Hospital.

PATIENTS:

70 infertile PCOS patients; 33 in GnRH antagonist and 37 in GnRH agonist group.

RESULTS:

Similar mature metaphase II oocyte rate (76% vs. 76%) was observed in both protocols. Optimal pronuclear morphology zygotes dominated in both groups (64% vs. 66%). Transferred embryo quality did not differ in both protocols. No significant differences between both protocols were found in delivery rate (p = 0.481), pregnancy rate (p = 0.810), multiple pregnancy rate (p = 0.501), miscarriage rate (p = 0.154), fertilization rate (p = 0.388) and implantation rate (p = 1.000). Duration of stimulation and total follicle-stimulating hormone (FSH) dose were significantly lower in GnRH antagonist protocol (p = 0.0005).

CONCLUSIONS:

GnRH antagonist and agonist protocols in non-obese PCOS patients yield similar embryological and clinical outcomes. Shorter duration of treatment and lower FSH requirement in GnRH antagonist group may be financially beneficial and therefore attractive for patients.

• Authors: Rafal Kurzawa, Przemyslaw Ciepiela, Tomasz Baczkowski, Krzysztof Safranow, Pawel Brelik
• Journal: Journal of assisted reproduction and genetics (J Assist Reprod Genet) Vol. 25 Issue 8 Pg. 365-74 (Aug 2008) ISSN: 1058-0468 [Print] Netherlands
• PMID: 18802744 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Gonadotropin-Releasing Hormone

Topics

• Abortion, Spontaneous
• Adult
• Female
• Fertilization
• Fertilization in Vitro (methods)
• Gonadotropin-Releasing Hormone (agonists, antagonists & inhibitors, therapeutic use)
• Humans
• Male
• Obesity (complications)
• Oocytes (cytology)
• Polycystic Ovary Syndrome (drug therapy)
• Pregnancy
• Pregnancy Rate
• Prospective Studies
• Spermatozoa (metabolism)
• Treatment Outcome