IVF/ICSI outcomes of the OCP plus GnRH agonist protocol versus the OCP plus GnRH antagonist fixed protocol in women with PCOS: a randomized trial

Abstract

Objective: To compare the IVF/ICSI outcomes of the long GnRH agonist and the fixed GnRH antagonist protocol in women with PCOS.

Design: Randomized controlled trial.

Setting: Baskent University Department of Obstetrics and Gynecology.

Patients: Three hundred women with PCOS.

Interventions: IVF/ICSI following the long GnRH agonist down-regulation or the fixed GnRH antagonist protocols.

Main outcome measures: Ongoing pregnancy rates.

Results: Ongoing pregnancy rates were 36.4 % in the OCP + GnRH agonist group and 35.9 % in the OCP + GnRH antagonist group (p > 0.05). Progesterone levels on the day of hCG (0.76 ± 0.71 vs. 0.58 ± 0.50), endometrial thickness on the day of hCG (11.57 ± 2.50 vs. 10.50 ± 2.01), total gonadotropin used (1388.71 ± 482.39 vs. 1253.25 ± 415.81), and duration of COH (9.07 ± 1.96 vs. 8.39 ± 1.75) were significantly lower in the OCP + GnRH antagonist group.

Conclusion: The OCP + long GnRH agonist and the OCP + fixed GnRH antagonist protocols yield similar ongoing pregnancy rates in women with PCOS. Although this study consisting three hundred patients, seems to be large enough in a single center, we were not able to reach to the actual size of power analysis which was approximately 3,000.