Gonadotrophin-releasing hormone antagonists for assisted conception

Al-Inany, Hesham; Abou‐Setta, Ahmed M; Aboulghar, Mohamed

doi:10.1002/14651858.cd001750.pub2

Cited by 152 publications

(107 citation statements)

References 32 publications

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“…Hwang et al [39] among PCOS patients stimulated with GnRH antagonist and GnRH agonist reported pregnancy rate per started cycle of 37% and 34.5%, respectively. While meta-analyse by Kolibianakis et al suggests that the probability of live birth is not dependent on the type of GnRH analogue used for suppression of premature LH rise/ surge [8], Al-Inany et al [9] showed significant lower the ongoing pregnancy/live-birth rate in the antagonist group. We observed a trend towards lower rates of delivery for GnRH antagonist group.…”

Section: Discussionmentioning

confidence: 98%

“…Meta-analysis by Kolibianakis et al [8] showed that the probability of the live birth does not differ between both protocols. On the other hand, the Al-Inany et al [9] metaanalysis revealed that GnRH antagonist gives significantly worse results than GnRH agonist in the general IVF population. However, most analyses demonstrate that GnRH antagonist protocols have certain advantages over agonists such as reduction of the duration of stimulation as well as the lower incidence of severe OHSS [8,9,10].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, the Al-Inany et al [9] metaanalysis revealed that GnRH antagonist gives significantly worse results than GnRH agonist in the general IVF population. However, most analyses demonstrate that GnRH antagonist protocols have certain advantages over agonists such as reduction of the duration of stimulation as well as the lower incidence of severe OHSS [8,9,10]. Meta-analysis by Griesinger et al showed similar benefits of GnRH analogs regarding PCOS populace [11].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study

Kurzawa

Ciepiela

Bączkowski

et al. 2008

J Assist Reprod Genet

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Purpose Embryological and clinical efficacy of gonadotropinreleasing hormone (GnRH) antagonist and agonist stimulation protocols in non-obese women with polycystic ovarian syndrome (PCOS) were compared. Methods A prospective randomized study. Setting: Medical University Hospital. Patients: 70 infertile PCOS patients; 33 in GnRH antagonist and 37 in GnRH agonist group. Results Similar mature metaphase II oocyte rate (76% vs. 76%) was observed in both protocols. Optimal pronuclear morphology zygotes dominated in both groups (64% vs. 66%). Transferred embryo quality did not differ in both protocols. No significant differences between both protocols were found in delivery rate ( p=0.481), pregnancy rate ( p=0.810), multiple pregnancy rate ( p=0.501), miscarriage rate ( p=0.154), fertilization rate ( p=0.388) and implantation rate (p=1.000). Duration of stimulation and total follicle-stimulating hormone (FSH) dose were significantly lower in GnRH antagonist protocol ( p=0.0005). Conclusions GnRH antagonist and agonist protocols in non-obese PCOS patients yield similar embryological and clinical outcomes. Shorter duration of treatment and lower FSH requirement in GnRH antagonist group may be financially beneficial and therefore attractive for patients.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study

Kurzawa

Ciepiela

Bączkowski

et al. 2008

J Assist Reprod Genet

View full text Add to dashboard Cite

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“…Multiple studies have shown that the use of GnRH antagonists in combination with gonadotropins is a safe and effective approach in this group of patients. 98,99 The use of oral contraceptives in the month prior to stimulation might help synchronize the oocyte cohort to be selected and promote a smoother increase in follicular size and estrogen production. 100 Additionally, the use of a contraceptive will be useful in scheduling these patients for their IVF cycle because they are often anovulatory and irregular.…”

Section: Ovarian Stimulationmentioning

confidence: 99%

Advances and Controversies in Assisted Reproductive Technology

Vela

Luna

Sandler

et al. 2009

Mount Sinai J Medicine

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As the incidence and awareness of infertility have increased in the last decades, reproductive endocrinologists and scientists have striven to improve the therapeutic options being offered to patients. One of the most advanced and efficient technologies currently being offered is assisted reproductive technology. Among the various techniques that are comprised by assisted reproductive technology, in vitro fertilization is the most widely studied and used, being responsible for approximately 1% of all live births in the United States. As this technology has evolved, many controversies have arisen, and it is the purpose of this article to review what in the authors' opinion are the most current and controversial aspects of the whole process of in vitro fertilization and its related techniques. Mt Sinai J Med 76:506‐520, 2009. © 2009 Mount Sinai School of Medicine

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“…However, even accomplishing similar estradiol levels, ovarian stimulation cycles using GnRH-antagonists down-regulation during in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) cycles have been reported to have worse pregnancy outcomes when compared to GnRH-agonists [4]. These results prompted the development of numerous small nuances to improve the stimulation outcomes.…”

Section: Introductionmentioning

confidence: 99%

Timing and duration of use of GnRH antagonist down-regulation for IVF/ICSI cycles have no impact on oocyte quality or pregnancy outcomes

Detti

Ambler

Yelian

et al. 2008

J Assist Reprod Genet

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Purpose To evaluate whether oocyte quality, implantation and pregnancy outcomes in in vitro fertilization (IVF)/ intra-cytoplasmic sperm injection (ICSI) are related to the duration of gonadotropin-releasing hormone (GnRH)-antagonist use or the timing of its initiation. Methods Retrospective cohort study of 178 conventional IVF/ICSI cycles. All patients underwent ovarian stimulation with gonadotropins and GnRH-antagonist for pituitary down-regulation. Spearman correlations and logistic regression were used for statistical analysis. Results There was no correlation between the duration of use or the timing of initiation of GnRH-antagonist with oocyte quality or implantation and pregnancy outcomes. Oocyte quality was influenced by the peak estradiol. Implantation was influenced by the patient's age. Early pregnancy loss, by the endometrial thickness on human chorionic gonadotropin-day. Ongoing pregnancy was independent from the variables evaluated.Conclusions GnRH-antagonist duration of use or starting day did not influence oocyte quality, implantation rates, and pregnancy rates. We hypothesize that a follicle stimulating hormone/luteinizing hormone dose increase when antagonist was started, may have had an impact on our findings.

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Gonadotrophin-releasing hormone antagonists for assisted conception

Cited by 152 publications

References 32 publications

Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study

Comparison of embryological and clinical outcome in GnRH antagonist vs. GnRH agonist protocols for in vitro fertilization in PCOS non-obese patients. A prospective randomized study

Advances and Controversies in Assisted Reproductive Technology

Timing and duration of use of GnRH antagonist down-regulation for IVF/ICSI cycles have no impact on oocyte quality or pregnancy outcomes

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