title: GnRH antagonist pre-treatment: one centre's experience for IVF-ICSI cycle scheduling.
abstract: Scheduling gonadotrophin-releasing hormone antagonist (GnRH-ant) cycles for IVF intracytoplasmic sperm injection in patients is a challenge because of unpredictable ovum retrieval procedures on weekends, when less manpower is available. Recently, the use of GnRH-ant pre-treatment to delay an IVF and intracytoplasmic sperm injection (ICSI) cycle showed no negative effect on clinical pregnancy rates. An age-matched, case-control study was conducted to evaluate the effectiveness of such pre-treatment for scheduling purposes. Patients (n = 140) undergoing their first ovarian stimulation for IVF-ICSI were included. Patients starting their stimulation on Tuesdays or Wednesdays were most likely to have their ovum retrieval procedure on Saturdays. Seventy patients received a 3-day course of GnRH-ant before starting stimulation, and were compared with 70 age-matched controls not receiving pre-treatment. The main outcomes were the proportion of ovum retrieval procedures occurring on Saturdays, clinical pregnancy rate and live birth rates. A five-fold reduction in the number of ovum retrievals occurred on Saturdays compared with controls (7.1% versus 34.3%; OR 0.15; 95% CI 0.05 to 0.42; P < 0.001), with no significant differences in clinical pregnancy rate (40.9% versus 37.5%) and live birth rate (27.3% versus 31.3%). GnRH-ant pre-treatment is an effective tool for scheduling of GnRH-ant cycles.
authors: Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899. Electronic address: veraxel3@yahoo.fr.
authors: Veronique
authors: V
authors: Viardot-Foucault
authors: Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899.
authors: Sadhana
authors: S
authors: Nadarajah
authors: Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore 169857.
authors: Weng Kit
authors: WK
authors: Lye
authors: Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899.
authors: Heng Hao
authors: HH
authors: Tan
mesh_terms: D000328:Adult; D001723:Birth Rate; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D006727:Hormone Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D006063:Chorionic Gonadotropin; D006727:Hormone Antagonists; D007987:Gonadotropin-Releasing Hormone; C061018:ganirelix
keywords: cycle scheduling; gonadotropin-releasing hormone antagonist; in-vitro fertilization; programming