Mini-dose GnRH-a long versus short protocol in patients ≥ 35 years old undergoing in vitro fertilization.
OBJECTIVE
To compare the clinical result of mini-dose GnRH-a long protocol with short protocol in older patients undergoing IVF.


METHODS
This was a retrospective study. Four hundred and sixty-one women aged above 35-year-old in first cycle were assigned to two groups: GnRH-a short protocol (n=359); and mini-dose GnRH-a long protocol (n=102). Both groups were divided based on their age, into groups over and under 38 years old. Primary outcome include live birth rate per started cycle. Other clinical outcomes were good-quality embryo rate, clinical pregnancy rate.


RESULTS
Patients treated with mini-dose GnRH-a protocol and those treated with short protocol showed similar live birth rate. In the mini-dose long protocol group aged 35-38 years old, patients showed significantly thicker endometrium at the day of hCG administration, higher number of good embryos obtained and higher good-quality embryo rate (56.3% versus 46.5%) compared with short protocol. The implantation rate and clinical pregnancy rate were higher versus short protocol group, but this result was not statistically significant.


CONCLUSIONS
Mini-dose GnRH-a long protocol for older women is at least as effective as short protocol, especially in patients aged 35-38 years, with a better good-quality embryo rate and higher number of good embryos obtained, therefore mini-dose GnRH-a long protocol can be considered as an alternative protocol for patients above 35 years age.
Center for Reproductive Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University , Shanghai , China and.
Hai-Jing
HJ
Xu
Xiao-Wei
XW
Ji
Yan
Y
Hong
Qin-Ling
QL
Zhu
Xiao-Ming
XM
Zhao
Yun
Y
Sun
D000328:Adult; D000367:Age Factors; D004717:Endometrium / Q000000981:diagnostic imaging / Q000502:physiology; D004958:Estradiol / Q000097:blood; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000188:drug therapy / Q000628:therapy*; D050498:Live Birth; D007986:Luteinizing Hormone / Q000097:blood; D054315:Oocyte Retrieval; D006080:Ovarian Follicle / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D012189:Retrospective Studies; D017329:Triptorelin Pamoate / Q000008:administration & dosage*; D014463:Ultrasonography
D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D007986:Luteinizing Hormone
Advanced reproductive age; GnRH agonist; in vitro fertilization; long protocol; mini-dose; short protocol