Comparison of GnRH antagonist with long GnRH agonist protocol after OCP pretreatment in PCOs patients

Abstract

Antagonist protocol and GnRH agonist trigger for ovulation whenever necessary has a similar cycle outcome to the GnRH-agonist protocol in OCP pretreated PCOs patients, with significantly reduced risk of OHSS.

Ovarian stimulation with GnRH analogues

“…As already established in the literature, both protocols are similar (Loutradis et al, 2004;Prapas et al, 2005;Xavier et al, 2005;Aletebi, 2007;Kurzawa et al, 2008;Hosseini et al, 2010;Tehraninejad et al, 2010;Al-Inany et al, 2011;Bodri et al, 2011;Gilliam, 2011;Pu et al, 2011;Haydardedeoglu et al, 2012;Pundir et al, 2012). We found the same results in our study.…”

“…We found the same results in our study. As demonstrated in this study, there is no difference in oocytes retrieval between these two protocols in recent meta analysis (Tehraninejad et al, 2010;Bodri et al, 2011;Pu et al, 2011;Casano et al, 2012;Pundir et al, 2012) and randomized controlled trials (Loutradis et al, 2004;Xavier et al, 2005;Kurzawa et al, 2008;Tazegul et al, 2008). Differently, some reports showed a less number of oocyte retrieval in the antagonist protocol (Barmat et al, 2005;Arruda et al, 2013;Orvieto & Patrizio, 2013).…”

Ovarian hyperstimulation syndrome: pathophysiology, staging, prediction and prevention

“…We identified 28 studies that compared the effect of using a GnRH antagonist with long GnRH agonist protocols in women undergoing ART. In 12 studies, the antagonist was used in daily doses, beginning on a fixed day of COS; in one study a single dose of long‐lasting antagonist was used; in 14 studies the antagonist was used in daily doses beginning on a flexible day depending on the size of the leading follicle; and one study did not provide sufficient details. The average incidence of OHSS in the control groups was 7.8%.…”

Early initiation of gonadotropin-releasing hormone antagonist in polycystic ovarian syndrome patients undergoing assisted reproduction: randomized controlled trial ISRCTN69937179

“…On the other hand, pretreatment with OCP prior to COS has been used extensively by many groups with satisfactory outcome [40,41]. Other investigators reported no deleterious effects of pretreatment with OCP in PCOS patients undergoing IVF/ET [6,[8][9][10]40]. In a recent prospective randomized controlled trial, Garcia-Velasco et al [42] concluded that the use of OCP to schedule patients undergoing the antagonist protocol has no negative effects on pregnancy outcome.…”

“…Although one retrospective study reported a significantly lower pregnancy rate with GnRH ant. compared to GnRH-a protocol in PCOS patients who underwent IVF/ET, several prospective randomized studies reported no difference in pregnancy, clinical pregnancy or delivery rates between the two protocols [4][5][6][7][8].…”