title: Are gonadotropin-releasing hormone agonists losing popularity? Current trends at a large fertility center.
abstract: OBJECTIVE
  To explore the long- and short-term trends in LH-suppression protocol use and patient profile characteristics.
  
  
  METHODS
  Descriptive study, retrospective cohort.
  
  
  METHODS
  Large, university-based IVF center.
  
  
  METHODS
  Four thousand five hundred one fresh IVF cycles categorized by use of GnRH antagonist, luteal GnRH agonist, and follicular microdose GnRH agonist.
  
  
  METHODS
  None.
  
  
  METHODS
  Frequency of use of LH-suppression protocol, patient and cycle characteristics, and outcomes at 10-year (1996-2005), 5-year (2001-5), and 3-year intervals (2004-6).
  
  
  RESULTS
  In both the <40 and >or=40 age groups, GnRH antagonist use increased from 2001 to 2005, while luteal GnRH agonist and microdose use decreased. The most recent luteal agonist patients were better responders and had higher implantation, clinical pregnancy, and delivery rates. Antagonist patients in the <40 and >or=40 age groups had a better response in 2005 than in 2001 with higher clinical pregnancy rates. Microdose patients responded worse in 2005 than in 2001, although pregnancy rates did not change significantly. Such trends were echoed from 2004 to 2006.
  
  
  CONCLUSIONS
  The target population for GnRH antagonist has broadened to include younger, normal responders in addition to the traditional poor responder. Luteal agonist and microdose protocols are chosen less frequently and remain targeted toward good and poor responders, respectively.
authors.affiliation: New York University Fertility Center, New York University School of Medicine, New York, New York, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Reh
authors.forename: Lewis
authors.initials: L
authors.lastname: Krey
authors.forename: Nicole
authors.initials: N
authors.lastname: Noyes
mesh_terms: D000328:Adult; D000367:Age Factors; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000639:trends*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006727:Hormone Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000097:blood / Q000628:therapy*; D050498:Live Birth; D007986:Luteinizing Hormone / Q000097:blood*; D008297:Male; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted / Q000639:trends*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone