What should be the protocol selection after failure of in-vitro fertilization at normoresponder patients: Agonist or antagonist?
- PMID: 28913019
- PMCID: PMC5558360
- DOI: 10.4274/tjod.03789
What should be the protocol selection after failure of in-vitro fertilization at normoresponder patients: Agonist or antagonist?
Abstract
Objective: Evaluation of the impact of agonist or antagonist protocol selection on pregnancy outcomes after failure of in-vitro fertilization (IVF) treatment cycles which were down regulated with Gonadotropin Releasing Hormone (GnRH) agonist.
Materials and methods: This was a retrospective study. Two hundred and sixty nine patients who were treated with GnRH agonist protocol between years 2002-2012 at an IVF unit and underwent a second attempt following one year period after failure of IVF enrolled in the study. Age, basal FSH levels, antral follicle counts, duration of induction, the number of yielded oocytes, the number of transferred embryos and the transfer days, clinical and ongoing pregnancy rates were evaluated for each treatment cycle.
Results: Normoresponder patients were separated into two groups according to the agonist or antagonist protocol selection at the second attempt and the results of two consequent IVF cycles were compared. There were no statistically significant difference between the groups for the dosage of administered gonadotropin, duration of induction, the count of yielded oocytes, the day and the number of transferred embryos (p>0.05). Furthermore the fertilization rate, clinical and ongoing pregnancy rates were similar in two groups.
Conclusion: The selection of antagonist treatment is effective as agonist protocols at normoresponder patients after failure of IVF.
Keywords: GnRH agonist; GnRH antagonist; in vitro fertilization; ovulation induction.
Conflict of interest statement
Conflict of Interest: The authors reported no conflict of interest related to this article.
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References
-
- Albano C, Felberbaum RE, Smitz J, Riethmüller-Winzen H, Engel J, Diedrich K, et al. Ovarian stimulation with HMG: results of a prospective randomized phase III European study comparing the luteinizing hormone-releasing hormone (LHRH)-antagonist cetrorelix and the LHRH-agonist buserelin. European Cetrorelix Study Group. Hum Reprod. 2000;15:526–31. - PubMed
-
- Felberbaum RE, Reissmann T, Küpker W, Bauer O, al Hasani S, Diedrich C, et al. Preserved pituitary response under ovarian stimulation with HMG and GnRH antagonists (Cetrorelix) in women with tubal infertility. Eur J Obstet Gynecol Reprod Biol. 1995;61:151–5. - PubMed
-
- Kolibianakis EM, Tarlatzis B, Devroey P. GnRH antagonists in IVF. Reprod Biomed Online. 2005;10:705–12. - PubMed
-
- Ludwig M, Katalinic A, Diedrich K. Use of GnRH antagonists in ovarian stimulation for assisted reproductive technologies compared to the long protocol Meta-analysis. Arch Gynecol Obstet. 2001;265:175–82. - PubMed
-
- Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L, et al. ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26:1616–24. - PubMed
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