[Comparison of agonists versus antagonists for i.v.f. stimulation: the French FIVNAT survey 2001-2002].
In 2002, FIVNAT has continued its study on the use and the results of the ovarian stimulation protocols using GnRH antagonist for i.v.f. and i.c.s.i. The first part of this study demonstrates that the antagonist protocols were still used in more pejorative cases than the long agonist protocols but with a smaller difference compared to 2001. So far, the frequency of the antagonist protocols has jumped from 13% to 19% from 2001 to 2002. This increase was mainly at the expense of the long agonist protocols. In the overall population, the lower pregnancy rate per ovum pick-up with antagonists, demonstrated in 2001, has been confirmed. In the second part of the study, FIVNAT has selected a good prognosis group (women's age less than 35 years and attempts rank lower than 3). This group includes 17,532 cycles with agonists and 3229 cycles with antagonists. A comparison of all the biological and clinical data was made. Finally, the pregnancy rate per ovum pick-up was significantly reduced when the stimulation was done with an antagonist protocol (Anta) rather than with a long agonist protocol (Ago). In i.v.f. these rates were 20.8% (Anta) versus 25.8% (Ago) (P < 0.001). In i.c.s.i. they were 21.9% (Anta) versus 29.4% (Ago) (P < 0.001). Moreover, the absolute and relative differences were the same in 2001 and 2002, suggesting that the learning curve effect does not explain the differences.
Pouly
J-L
JL
FIVNAT et unité INSERM U569, CHU Bicêtre, 82, avenue du Général Leclerc, 94276 Le Kremlin-Bicêtre, France. pouly.jean@wanadoo.fr
Bachelot
A
A
de Mouzon
J
J
Devaux
A
A
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005602:France; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy
D007987:Gonadotropin-Releasing Hormone
Comparaison agonistes / antagonistes dans les stimulations pour FIV: les données de FIVNAT 2001-2002.