title: Effect of length of controlled ovarian hyperstimulation using a gonadotropin-releasing hormone antagonist on in vitro fertilization pregnancy rates.
abstract: OBJECTIVE
  To compare pregnancy outcomes between shorter and longer in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles using GnRH antagonist protocol.
  
  
  METHODS
  Retrospective cohort analysis at a large military academic hospital. A total of 351 patients underwent 412 IVF/ICSI cycles using a GnRH antagonist protocol from September 2002 through May 2008. Clinical pregnancy and live birth rates for all IVF/ICSI cycles were compared independently for both total length of ovarian stimulation with gonadotropins (< 10 days vs. > or = 10 days) and GnRH antagonist use (< 4 days vs. > or = 4 days), respectively.
  
  
  RESULTS
  Clinical pregnancy rates were 54.6% among cycles with total gonadotropin use <10 days vs. 48.6% for those cycles > or = 10 days, odds ratio 0.82 (0.53-1.27); live birth rates were 50.0% vs. 47.7%, odds ratio 0.91 (0.59-1.42). Clinical pregnancy rates were 54.0% among cycles with GnRH antagonist use < 4 days vs. 52.8% with GnRH antagonist use > or = 4 days, odds ratio 0.95 (0.62-1.45); live birth rates were 46.8% vs. 50.4%, odds ratio 1.15 (0.76-1.76).
  
  
  CONCLUSIONS
  Clinical pregnancy and live birth rates are not adversely affected by longer IVF/ICSI cycles using GnRH antagonists.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, San Antonio Uniformed Services Health Education Consortium, San Antonio Military Medical Center, Lackland Air Force Base, San Antonio, Texas, USA. donroystermd@gmail.com
authors.forename: G Donald
authors.initials: GD
authors.lastname: Royster
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Retzloff
authors.forename: Randal D
authors.initials: RD
authors.lastname: Robinson
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: King
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Propst
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D050498:Live Birth; D054315:Oocyte Retrieval; D006080:Ovarian Follicle; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D012102:Reproductive Control Agents / Q000008:administration & dosage; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D006063:Chorionic Gonadotropin; D006727:Hormone Antagonists; D012102:Reproductive Control Agents; D007987:Gonadotropin-Releasing Hormone; C061018:ganirelix