Cetrorelix protocol versus gonadotropin-releasing hormone analog suppression long protocol for superovulation in intracytoplasmic sperm injection patients older than 40

Abstract

Objective: To determine which protocols work better between cetrorelix and long protocols in older patients in a randomized controlled study.

Design: A controlled randomized study in a single private IVF center.

Setting: Infertile women referred to a private IVF center.

Patient(s): Five hundred sixty-four women 40 years or older undergoing IVF.

Intervention(s): At their first IVF cycle, the women were randomized into two study groups using a computer-generated number sequence: 281 cases were treated with the cetrorelix protocol, and 283 patients were treated with a long protocol for controlled ovarian hyperstimulation.

Main outcome measure(s): Days of stimulation, E(2) on the day of hCG administration, amount of FSH administered, number of oocytes yielded, number of embryos obtained, pregnancy rate, and implantation rate.

Result(s): Patients treated with the long protocol showed a significantly higher number of oocytes retrieved and a higher pregnancy rate for both the cycle and transfer with respect to the cetrorelix protocol patients. The other parameter evaluated did not show any statistically significant differences.

Conclusion(s): Our study showed that the long protocol performed better in older women than the cetrorelix protocol and that the GnRH antagonist may be detrimental in older women.