Fixed versus flexible antagonist protocol in women with predicted high ovarian response except PCOS: a randomized controlled trial

Autor: Li Pei, Xiu Luo, Hong Ye, Chunli Li, Fujie Li, Guoning Huang
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Pregnancy Rate
medicine.medical_treatment
Stimulation
Chorionic Gonadotropin
law.invention
Fixed protocol
Gonadotropin-Releasing Hormone
0302 clinical medicine
Randomized controlled trial
law
Pregnancy
In vitro fertilization
Number of oocytes retrieved
Medicine
Ganirelix
030219 obstetrics & reproductive medicine
Triptorelin Pamoate
Obstetrics and Gynecology
Recombinant Proteins
medicine.anatomical_structure
Treatment Outcome
Female
Follicle Stimulating Hormone
Human
Gonadotropin
Flexible protocol
Infertility
Female
medicine.drug
Research Article
Polycystic Ovary Syndrome
Adult
medicine.medical_specialty
medicine.drug_class
Ovary
Fertilization in Vitro
03 medical and health sciences
Follicle
Young Adult
Ovulation Induction
Internal medicine
Humans
In vitro fertilisation
business.industry
Antagonist
Gonadotropin-releasing hormone antagonists
Gynecology and obstetrics
Endocrinology
RG1-991
business
030217 neurology & neurosurgery
Zdroj: BMC Pregnancy and Childbirth
BMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-7 (2021)
ISSN: 1471-2393
0263-5607
Popis: Background No previous study directly compares the fixed day-5 initiation versus the flexible initiation of GnRH antagonist administration in IVF/ICSI for those patients who are predicted as high ovarian responders without PCOS. To evaluate whether the number of oocytes retrieved is different by using the two GnRH antagonist protocols in Chinese women with predicted high ovarian response except PCOS. Methods A randomized controlled trial of 201 infertile women with predicted high ovarian response except PCOS undergoing in vitro fertilization. Ovary stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist ganirelix (0.25 mg/d) was started either on day 5 of stimulation (fixed group) or when LH was > 10 IU/L, and/or a follicle with mean diameter > 12 mm was present, and/or serum E2 was > 600 pg/ml. Patient monitoring was initiated on day 3 of stimulation in flexible group. Result(s) No significant difference was observed between the fixed and flexible groups regarding the number of oocytes retrieved (16.72 ± 7.25 vs. 17.47 ± 5.88, P = 0.421), the Gonadotropin treatment duration (9.53 ± 1.07 vs. 9.67 ± 1.03, P = 0.346) and total Gonadotropin dose (1427.75 ± 210.6 vs. 1455.94 ± 243.44, P = 0.381). GnRH antagonist treatment duration in fixed protocol was statistically longer than the flexible protocol (6.57 ± 1.17 vs 6.04 ± 1.03, P = 0.001). There was no premature LH surge in either protocol. Conclusion(s) Fixed GnRH antagonist administration on day 5 of stimulation appear to achieve a comparable oocyte retrieved compared with flexible antagonist administration. Trial registration NCT02635607 posted on December 16, 2015 in clinicaltrials.gov.
Databáze: OpenAIRE
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