Early cleavage does not predict treatment outcome following the use of GnRH antagonists in women older than 35.
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.
Yang
Wen-Jui
WJ
Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan.
Hwu
Yuh-Ming
YM
Lee
Robert Kuo-kuang
RK
Li
Sheng-Hsiang
SH
Lin
Shyr-Yeu
SY
Fleming
Steven
S
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
D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins