title: Selection of first in vitro fertilization cycle stimulation protocol for good prognosis patients: gonadotropin releasing hormone antagonist versus agonist protocols.
abstract: OBJECTIVE
  The objective of this study was to compare outcome parameters in patients anticipated to have a good response to stimulation based upon baseline characteristics using either a gonadotropin releasing hormone (GnRH) agonist or antagonist protocol in their first in vitro fertilization (IVF) cycle.
  
  
  METHODS
  A retrospective chart review of all first-time IVF cycles performed during the time period 2005 through 2007 in an academic teaching center. Patients <40 years of age with a normal baseline follicle stimulating hormone (<10 mIU/mL) and normal antral follicle counts (> or = 3 in each ovary) were included. All patients studied were undergoing their first IVF cycle. The main outcome measures were clinical pregnancy and live birth rates.
  
  
  RESULTS
  Included in the study were 755 patients undergoing a GnRH agonist protocol and 378 patients undergoing a GnRH antagonist cycle. Implantation rates (39.4% vs. 39.5%), cancellation rates (22.4% vs. 19.2%), clinical pregnancy rates (43.6% vs. 48.6%) and live birth rates (34.9% vs. 40.1%) were similar between GnRH antagonist and GnRH agonist protocol groups, respectively.
  
  
  CONCLUSIONS
  Clinical pregnancy and live birth rates are similar in good responders utilizing either a GnRH agonist or antagonist during their first cycle of IVF.
authors.affiliation: Wake Forest University Center for Reproductive Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Erika B
authors.initials: EB
authors.lastname: Johnston-MacAnanny
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: DiLuigi
authors.forename: Lawrence L
authors.initials: LL
authors.lastname: Engmann
authors.forename: Donald B
authors.initials: DB
authors.lastname: Maier
authors.forename: Claudio A
authors.initials: CA
authors.lastname: Benadiva
authors.forename: John C
authors.initials: JC
authors.lastname: Nulsen
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D015925:Cryopreservation; D004622:Embryo, Mammalian; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000037:antagonists & inhibitors*; D006801:Humans; D008596:Menotropins / Q000008:administration & dosage; D006080:Ovarian Follicle / Q000033:anatomy & histology; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D008596:Menotropins; D005640:Follicle Stimulating Hormone