title: Cetrorelix protocol versus gonadotropin-releasing hormone analog suppression long protocol for superovulation in intracytoplasmic sperm injection patients older than 40.
abstract: 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.
authors.affiliation: Center of Endocrinology and Reproductive Medicine, Rome, Italy. marcandrea@hotmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Sbracia
authors.forename: Julio
authors.initials: J
authors.lastname: Colabianchi
authors.forename: Annalise
authors.initials: A
authors.lastname: Giallonardo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Giannini
authors.forename: Claudio
authors.initials: C
authors.lastname: Piscitelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Morgia
authors.forename: Monica
authors.initials: M
authors.lastname: Montigiani
authors.forename: Mauro
authors.initials: M
authors.lastname: Schimberni
mesh_terms: 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*
chemical_list: C422364:inhibin B; D007987:Gonadotropin-Releasing Hormone; D007265:Inhibins; C062876:cetrorelix