Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
- PMID: 40567909
- PMCID: PMC12186172
- DOI: 10.18502/ijrm.v23i3.18775
Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
Abstract
Background: Women with low ovarian reserve are the capable part of people who refer to infertility centers, this study compares 2 treatment protocols in cases with low ovarian reserve.
Objective: This study aimed to compare the efficacy of gonadotropin-releasing hormone (GnRH) agonist and GnRH-antagonist protocols in women with diminished ovarian reserve (DOR) in POSEIDON groups 3-4 undergoing in assisted reproductive technology (ART).
Materials and methods: This randomized clinical trial enrolled 158 infertile women with diminished ovarian reserve undergoing ART at the Research and Clinical Center for Infertility, Yazd, Iran from January to October 2024. Women were randomly assigned to either a GnRH-antagonist (n = 84) or a long GnRH-agonist (n = 74). Primary outcomes included clinical pregnancy and secondary outcomes were chemical pregnancy, early abortion rate, ongoing pregnancy, and implantation rate.
Results: No significant differences were observed in baseline values between groups. The GnRH-agonist group had a longer stimulation duration (12.23 vs. 10.60 days, p 0.001) and a higher total gonadotropin dose (4588.84 vs. 3225.67 IU, p 0.001) compared to the antagonist group. Clinical pregnancy rates (17.8% vs. 15.8%, p = 0.810) and live birth rates (11.1% vs. 13.2%, p = 0.775) were comparable between the agonist and antagonist groups.
Conclusion: According to acquired data, the GnRH-antagonist and long GnRH-agonist protocols resulted in similar ART outcomes. The antagonist protocol was associated with shorter stimulation and lower gonadotropin consumption. As a result, the antagonist protocol was found to be more cost effective. Larger studies are needed to confirm these results and determine the optimal protocol for this woman group.
Keywords: ART.; In vitro fertilization; Ovarian stimulation; Ovarian reserve.
Copyright © 2025 Aminimajomerd et al.
Conflict of interest statement
The authors declare that there is no conflict of interest.
Similar articles
-
Oral medications including clomiphene citrate or aromatase inhibitors with gonadotropins for controlled ovarian stimulation in women undergoing in vitro fertilisation.Cochrane Database Syst Rev. 2017 Nov 2;11(11):CD008528. doi: 10.1002/14651858.CD008528.pub3. Cochrane Database Syst Rev. 2017. PMID: 29096046 Free PMC article.
-
Gonadotrophin-releasing hormone antagonists for assisted reproductive technology.Cochrane Database Syst Rev. 2016 Apr 29;4(4):CD001750. doi: 10.1002/14651858.CD001750.pub4. Cochrane Database Syst Rev. 2016. PMID: 27126581 Free PMC article.
-
Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques.Cochrane Database Syst Rev. 2017 May 25;5(5):CD006109. doi: 10.1002/14651858.CD006109.pub3. Cochrane Database Syst Rev. 2017. PMID: 28540977 Free PMC article.
-
What is the optimal GnRH antagonist protocol for ovarian stimulation during ART treatment? A systematic review and network meta-analysis.Hum Reprod Update. 2023 May 2;29(3):307-326. doi: 10.1093/humupd/dmac040. Hum Reprod Update. 2023. PMID: 36594696 Free PMC article.
-
SHR7280, an oral gonadotropin-releasing hormone antagonist, for the prevention of premature luteinizing hormone surge in controlled ovarian hyperstimulation: a dose-finding, phase 2 trial.Hum Reprod. 2025 Jul 1;40(7):1357-1365. doi: 10.1093/humrep/deaf082. Hum Reprod. 2025. PMID: 40373184 Clinical Trial.
References
-
- Koloda Y, Korsak V, Rozenson O, Anshina M, Sagamonova K, Baranov I, et al. Use of a recombinant human follicle-stimulating hormone: Recombinant human luteinizing hormone (r-hFSH: r-hLH) 2:1 combination for controlled ovarian stimulation during assisted reproductive technology treatment: A real-world study of routine practice in the Russian Federation. Best Pract Res Clin Obstet Gynaecol. 2022;85:134–148. - PubMed
LinkOut - more resources
Full Text Sources
Research Materials