open access

Vol 87, No 4 (2016)
ORIGINAL PAPERS Gynecology
Published online: 2016-05-23
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Flexible GnRH antagonist protocol vs. long GnRH agonist protocol in patients with polycystic ovary syndrome treated for IVF: comparison of clinical outcome and embryo quality

Milan Trenkić, Jasmina Popović, Vesna Kopitović, Artur Bjelica, Radomir Živadinović, Sonja Pop-Trajković
DOI: 10.17772/gp/62205
·
Pubmed: 27321097
·
Ginekol Pol 2016;87(4):265-270.

open access

Vol 87, No 4 (2016)
ORIGINAL PAPERS Gynecology
Published online: 2016-05-23

Abstract

Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder, primarily affecting women of the reproductive age. The aim of the study was to assess the clinical efficacy and embryo quality in flexible gonadotropin-releasing hormone (GnRH) antagonist protocol in comparison to the long GnRH agonist protocol in PCOS women undergoing in vitro fertilization (IVF).

Material and methods: This prospective, randomized study was conducted at the Department of Gynecology and Obstetrics, Clinical Center Niš, Serbia, between 2013 and 2014. The treatment included either a flexible GnRH antagonist protocol (n = 45, antagonist group) or a long GnRH agonist protocol (n = 45, agonist group).

Results: The length of the stimulation, total amount of gonadotropins used, as well as the average number of the aspirated and mature oocytes were higher in the agonists group. The endometrial thickness was also greater in the agonists group. A higher number of Class I and Class IV embryos were obtained after the agonist treatment and higher number of Class II and Class III embryos were obtained after the antagonist treatment. Pregnancy, implantation, and miscarriage rates were comparable between the groups.

Conclusions: The GnRH antagonist protocol in PCOS patients has a pregnancy rate comparable to that of the GnRH agonist protocol. Since this protocol has a lower rate of complications and is more convenient for patients, we believe that the GnRH antagonist protocol should be used as the first-line treatment for PCOS patients in an IVF program.

Abstract

Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder, primarily affecting women of the reproductive age. The aim of the study was to assess the clinical efficacy and embryo quality in flexible gonadotropin-releasing hormone (GnRH) antagonist protocol in comparison to the long GnRH agonist protocol in PCOS women undergoing in vitro fertilization (IVF).

Material and methods: This prospective, randomized study was conducted at the Department of Gynecology and Obstetrics, Clinical Center Niš, Serbia, between 2013 and 2014. The treatment included either a flexible GnRH antagonist protocol (n = 45, antagonist group) or a long GnRH agonist protocol (n = 45, agonist group).

Results: The length of the stimulation, total amount of gonadotropins used, as well as the average number of the aspirated and mature oocytes were higher in the agonists group. The endometrial thickness was also greater in the agonists group. A higher number of Class I and Class IV embryos were obtained after the agonist treatment and higher number of Class II and Class III embryos were obtained after the antagonist treatment. Pregnancy, implantation, and miscarriage rates were comparable between the groups.

Conclusions: The GnRH antagonist protocol in PCOS patients has a pregnancy rate comparable to that of the GnRH agonist protocol. Since this protocol has a lower rate of complications and is more convenient for patients, we believe that the GnRH antagonist protocol should be used as the first-line treatment for PCOS patients in an IVF program.

Get Citation

Keywords

IVF; PCOS; GnRH agonist; GnRH antagonist

About this article
Title

Flexible GnRH antagonist protocol vs. long GnRH agonist protocol in patients with polycystic ovary syndrome treated for IVF: comparison of clinical outcome and embryo quality

Journal

Ginekologia Polska

Issue

Vol 87, No 4 (2016)

Pages

265-270

Published online

2016-05-23

DOI

10.17772/gp/62205

Pubmed

27321097

Bibliographic record

Ginekol Pol 2016;87(4):265-270.

Keywords

IVF
PCOS
GnRH agonist
GnRH antagonist

Authors

Milan Trenkić
Jasmina Popović
Vesna Kopitović
Artur Bjelica
Radomir Živadinović
Sonja Pop-Trajković

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