title: In vitro fertilization stimulation protocol for normal responder patients.
abstract: The aim of this prospective observational study is to determine the different outcomes of IVF/ICSI treatments after using antagonists or agonists of gonadotrophin-releasing hormone (GnRH) for controlled ovarian hyperstimulation (COH) in normal responder patients. Two hundred forty-seven patients undergoing IVF treatment at the Centre of Reproductive Medicine, Rome (CERMER), from January 2005 to December 2008, were included in the study. Patients were stimulated either with a standard long protocol with GnRH agonists (n = 156) or with GnRH antagonists (n = 91). The use of GnRH antagonists resulted in a significant reduction in the duration of the stimulation (Agonist Group 14.10 ± 2.25 vs Antagonist Group 11.34 ± 2.11; p < 0.001) and in the amount of gonadotrophin (IU of r-FSH) needed (Agonist Group 1878 ± 1109 vs Antagonist Group 1331 ± 1049; p = 0.0014). Moreover a lower number of cycles were cancelled with the antagonist protocol (4.39 vs 6.41%). The GnRH antagonist protocol, when compared to the GnRH agonist one, is associated with a similar clinical pregnancy rate, similar implantation rate, significantly lower gonadotrophin requirement and shorter duration of stimulation. For this reason, GnRH antagonists might be a good treatment even for normal responder patients undergoing IVF.
authors.affiliation: Department of Biomedical Sciences and Advanced Therapies, University of Ferrara, Ferrara, Italy. roberto.marci@unife.it
authors.forename: R
authors.initials: R
authors.lastname: Marci
authors.forename: D
authors.initials: D
authors.lastname: Caserta
authors.forename: F
authors.initials: F
authors.lastname: Lisi
authors.forename: A
authors.initials: A
authors.lastname: Graziano
authors.forename: I
authors.initials: I
authors.lastname: Soave
authors.forename: G
authors.initials: G
authors.lastname: Lo Monte
authors.forename: A
authors.initials: A
authors.lastname: Patella
authors.forename: M
authors.initials: M
authors.lastname: Moscarini
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D004958:Estradiol / Q000097:blood / Q000378:metabolism; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D043373:Follicle Stimulating Hormone, Human / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000009:adverse effects / Q000819:agonists / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors* / Q000494:pharmacology; D006727:Hormone Antagonists / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D054315:Oocyte Retrieval; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D012384:Rome / Q000453:epidemiology; D020554:Sperm Injections, Intracytoplasmic; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D043373:Follicle Stimulating Hormone, Human; D006727:Hormone Antagonists; D011994:Recombinant Proteins; C571801:follitropin alfa; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; C061018:ganirelix