Comparison of GnRH antagonist with long GnRH agonist protocol after OCP pretreatment in PCOs patients.
OBJECTIVE
To evaluate the efficacy of GnRH antagonist in comparison with the GnRH agonist protocol in OCP pretreated polycystic ovary syndrome (PCOs) patients undergoing their first ART cycle.


METHODS
Prospective randomized controlled trial. University-based tertiary fertility center. Ninety-five PCOs patients under 35 years of age, with primary infertility were randomized to an ovarian stimulation protocol consisting of either. GnRh antagonist (study group) or GnRH agonist (control group) after pretreatment with OCP. Coasting or GnRH agonist Trigger was used when estradiol level > or =3,000 pgr/ml in the control and study group, respectively. Both groups received 800 mg vaginal progesterone and 4 mg oral estradiol valerate for luteal phase support.


RESULTS
There was no statistically significant difference in the age, body mass index, basal FSH, duration of infertility, the number of oocytes retrieved, the number of embryos transferred, Serum E2 levels on day of trigger, fertilization rate, chemical and clinical pregnancy rates between the two groups. None of the patients in the study group developed ovarian hyperstimulation syndrome (OHSS) compared with 22.2% of patients in the control group. Total duration of treatment and the number of HMG ampoules used were lower in the study group.


CONCLUSIONS
Antagonist protocol and GnRH agonist trigger for ovulation whenever necessary has a similar cycle outcome to the GnRH-agonist protocol in OCP pretreated PCOs patients, with significantly reduced risk of OHSS.
Tehraninejad
Ensieh Shahrokh
ES
Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Nasiri
Roya
R
Rashidi
Batool
B
Haghollahi
Fedieh
F
Ataie
Marzieh
M
D000328:Adult; D002064:Buserelin / Q000008:administration & dosage; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019304:Ethinyl Estradiol-Norgestrel Combination / Q000008:administration & dosage; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists* / Q000031:analogs & derivatives*; D006727:Hormone Antagonists / Q000008:administration & dosage*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D008596:Menotropins / Q000008:administration & dosage*; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy; D011247:Pregnancy; D018873:Pregnancy Rate; D055815:Young Adult
D003277:Contraceptives, Oral, Combined; D005300:Fertility Agents, Female; D006727:Hormone Antagonists; C527545:hMG-IBSA; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins; D019304:Ethinyl Estradiol-Norgestrel Combination; C062876:cetrorelix; D002064:Buserelin