Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study.
OBJECTIVE
Embryological and clinical efficacy of gonadotropin-releasing hormone (GnRH) antagonist and agonist stimulation protocols in non-obese women with polycystic ovarian syndrome (PCOS) were compared.


METHODS
A prospective randomized study.


METHODS
Medical University Hospital.


METHODS
70 infertile PCOS patients; 33 in GnRH antagonist and 37 in GnRH agonist group.


RESULTS
Similar mature metaphase II oocyte rate (76% vs. 76%) was observed in both protocols. Optimal pronuclear morphology zygotes dominated in both groups (64% vs. 66%). Transferred embryo quality did not differ in both protocols. No significant differences between both protocols were found in delivery rate (p = 0.481), pregnancy rate (p = 0.810), multiple pregnancy rate (p = 0.501), miscarriage rate (p = 0.154), fertilization rate (p = 0.388) and implantation rate (p = 1.000). Duration of stimulation and total follicle-stimulating hormone (FSH) dose were significantly lower in GnRH antagonist protocol (p = 0.0005).


CONCLUSIONS
GnRH antagonist and agonist protocols in non-obese PCOS patients yield similar embryological and clinical outcomes. Shorter duration of treatment and lower FSH requirement in GnRH antagonist group may be financially beneficial and therefore attractive for patients.
Kurzawa
Rafal
R
Department of Reproductive Medicine and Gynecology, Pomeranian Medical University, Szczecin-Police, Poland.
Ciepiela
Przemyslaw
P
Baczkowski
Tomasz
T
Safranow
Krzysztof
K
Brelik
Pawel
P
D000022:Abortion, Spontaneous; D000328:Adult; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications; D009865:Oocytes / Q000166:cytology; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013094:Spermatozoa / Q000378:metabolism; D016896:Treatment Outcome
D007987:Gonadotropin-Releasing Hormone