GnRH agonist long protocol vs. a single 3-mg gnRH antagonist: a comparison of 2 protocols for pituitary down-regulation in oocyte donor-controlled ovarian hyperstimulation cycles.
OBJECTIVE
To compare ovarian stimulation outcomes for 2 protocols of pituitary down-regulation in a group of fertile women.


METHODS
Retrospective outcome analysis of 35 healthy oocyte donors participating in a university-affiliated in vitro fertilization donor program from 1999 to 2004. Consecutive donor cycles were grouped according to the agent used for down-regulation (n = 27 GnRH agonist, n = 31 GnRH antagonist). Statistical analysis was performed using ANOVA, chi2 and Wilcoxon Rank Sum tests.


RESULTS
Neither gonadotropin dosage, days of stimulation or number of oocytes retrieved per treatment cycle were statistically different between groups. The only significant embryo quality parameter was more grade D embryos in the GnRH antagonist (0.4 +/- 0.6) vs. GnRH agonist arm (0.0 +/- 0.2). The number of embryos transferred was significantly greater for the GnRH agonist (2.7 +/- 0.5) than GnRH antagonist arm (1.0 +/- 0.5), whereas implantation and clinical pregnancy rates were not significantly different between groups. No patient experienced the ovarian hyperstimulation syndrome.


CONCLUSIONS
Since there was no significant difference in the biologic effects of the 2 protocols, the use of a 3-mg GnRH antagonist for down-regulation in a donor program is preferable to the long protocol because it requires only 1-2 injections for pituitary down-regulation.
Reproductive Endocrinology and Infertility, University of Pittsburgh Physicians, Pittsburgh, Pennsylvania 15213, USA. erbtm@msx.upmc.edu
Teresa M
TM
Erb
Anthony N G
AN
Wakim
D000328:Adult; D002985:Clinical Protocols; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors*; D006801:Humans; D018587:Oocyte Donation; D010062:Ovulation Induction / Q000379:methods*; D012189:Retrospective Studies
D007987:Gonadotropin-Releasing Hormone