Cetrorelix protocol versus gonadotropin-releasing hormone analog suppression long protocol for superovulation in intracytoplasmic sperm injection patients older than 40.
OBJECTIVE
To determine which protocols work better between cetrorelix and long protocols in older patients in a randomized controlled study.


METHODS
A controlled randomized study in a single private IVF center.


METHODS
Infertile women referred to a private IVF center.


METHODS
Five hundred sixty-four women 40 years or older undergoing IVF.


METHODS
At their first IVF cycle, the women were randomized into two study groups using a computer-generated number sequence: 281 cases were treated with the cetrorelix protocol, and 283 patients were treated with a long protocol for controlled ovarian hyperstimulation.


METHODS
Days of stimulation, E(2) on the day of hCG administration, amount of FSH administered, number of oocytes yielded, number of embryos obtained, pregnancy rate, and implantation rate.


RESULTS
Patients treated with the long protocol showed a significantly higher number of oocytes retrieved and a higher pregnancy rate for both the cycle and transfer with respect to the cetrorelix protocol patients. The other parameter evaluated did not show any statistically significant differences.


CONCLUSIONS
Our study showed that the long protocol performed better in older women than the cetrorelix protocol and that the GnRH antagonist may be detrimental in older women.
Sbracia
Marco
M
Center of Endocrinology and Reproductive Medicine, Rome, Italy. marcandrea@hotmail.com
Colabianchi
Julio
J
Giallonardo
Annalise
A
Giannini
Pierluigi
P
Piscitelli
Claudio
C
Morgia
Francesco
F
Montigiani
Monica
M
Schimberni
Mauro
M
D000328:Adult; D000367:Age Factors; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D006801:Humans; D007265:Inhibins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic; D013480:Superovulation / Q000187:drug effects*
C422364:inhibin B; D007987:Gonadotropin-Releasing Hormone; D007265:Inhibins; C062876:cetrorelix