title: Early cleavage does not predict treatment outcome following the use of GnRH antagonists in women older than 35.
abstract: OBJECTIVE
  To compare the early-cleavage rates and the implantation potential of embryos between the GnRH antagonist and agonist long stimulation protocols in women older than 35 years.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Two hundred twenty patients older than 35 years old underwent IVF.
  
  
  METHODS
  Sixty-eight patients received GnRH antagonist protocol (GnRH antagonist group) and 152 patients received GnRH agonist long stimulation protocol (GnRH agonist group).
  
  
  METHODS
  Early-cleavage rate of zygotes, implantation rate, and pregnancy rate.
  
  
  RESULTS
  Early-cleavage rate of zygotes was significantly lower in the GnRH antagonist group than agonist group (21.8% vs. 32.6%, P<.0001). In the GnRH antagonist group, the pregnancy rate was not significantly different between the early-cleavage and late-cleavage subgroups (40.0% vs. 47.4%). In the GnRH agonist group, the pregnancy rate was significantly higher in the early-cleavage subgroup than in the late-cleavage subgroup (61.0% vs. 29.8%, P<.0001).
  
  
  CONCLUSIONS
  In women older than 35 years, the early-cleavage rate of zygotes is significantly lower in the GnRH antagonist group than the agonist group. Early-cleavage status of zygotes is not a reliable predictor for embryo implantation in patients receiving the GnRH antagonist protocol.
authors.affiliation: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Wen-Jui
authors.initials: WJ
authors.lastname: Yang
authors.forename: Yuh-Ming
authors.initials: YM
authors.lastname: Hwu
authors.forename: Robert Kuo-kuang
authors.initials: RK
authors.lastname: Lee
authors.forename: Sheng-Hsiang
authors.initials: SH
authors.lastname: Li
authors.forename: Shyr-Yeu
authors.initials: SY
authors.lastname: Lin
authors.forename: Steven
authors.initials: S
authors.lastname: Fleming
mesh_terms: D000328:Adult; D000367:Age Factors; D002470:Cell Survival; D002970:Cleavage Stage, Ovum / Q000502:physiology*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D043373:Follicle Stimulating Hormone, Human / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000037:antagonists & inhibitors*; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis* / Q000628:therapy*; D008596:Menotropins / Q000627:therapeutic use; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins