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

J Assist Reprod Genet. 2008 Aug;25(8):365-74. doi: 10.1007/s10815-008-9249-7. Epub 2008 Sep 19.

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

  • Gonadotropin-Releasing Hormone