Gonadotropin-Releasing Hormone (GnRH)-Antagonist Versus GnRH-Agonist in Ovarian Stimulation of Poor Responders Undergoing IVF

Autor: Arye Hurwitz, Alex Simon, Sozos J. Fasouliotis, Shelley Sabbagh-Ehrlich, Neri Laufer, A. Lewin
Rok vydání: 2003
Předmět:
Adult
endocrine system
medicine.medical_specialty
endocrine system diseases
Pregnancy Rate
Pregnancy
High-Risk
medicine.medical_treatment
Fertilization in Vitro
Gonadotropin-releasing hormone
Hormone antagonist
Article
Gonadotropin-Releasing Hormone
Hormone Antagonists
Ovulation Induction
Pregnancy
Genetics
medicine
Humans
Prospective cohort study
reproductive and urinary physiology
Genetics (clinical)
Retrospective Studies
Gynecology
Triptorelin Pamoate
business.industry
Pregnancy Outcome
Obstetrics and Gynecology
Retrospective cohort study
General Medicine
Embryo Transfer
medicine.disease
female genital diseases and pregnancy complications
Embryo transfer
Pregnancy rate
Reproductive Medicine
Female
Ovulation induction
business
hormones
hormone substitutes
and hormone antagonists
Maternal Age
Developmental Biology
Zdroj: Journal of Assisted Reproduction and Genetics. 20:455-460
ISSN: 1058-0468
DOI: 10.1023/b:jarg.0000006707.88826.e7
Popis: Purpose: The objective of this study was to compare the efficacy of GnRH-antagonists to GnRH-agonists in ovarian stimulation of poor responders undergoing IVF. Methods: Retrospective analysis of our data revealed that 56 patients underwent treatment with a GnRH-agonist according to the flare-up protocol. Patients failing to achieve an ongoing pregnancy (n=53) were subsequently treated in the next cycle with a GnRH-antagonist according to the multiple-dose protocol. Main outcome measures included the clinical pregnancy and implantation rates. Results: While ovulation induction characteristics and results did not differ between the two protocols, the number of embryos transferred was significantly higher (P=0.046) in the GnRH-antagonist than in the GnRH-agonist stimulation protocol (2.5 ± 1.6 vs. 2.0 ± 1.4, respectively). The clinical pregnancy and implantation rates per transfer in the GnRH-antagonist group appeared higher than in the GnRH-agonist, but did not differ statistically (26.1 and 10.7 compared with 12.2 and 5.9%, respectively). However, the ongoing pregnancy rate per transfer was statistically significantly higher (P=0.03) in the GnRH-antagonist than in the GnRH-agonist group (23.9 vs. 7.3%, respectively). Conclusion: Applying GnRH-antagonists to ovarian stimulation protocols may offer new hope for IVF poor responder patients. However, further controlled randomized prospective studies with larger sample sizes are required to establish these results.
Databáze: OpenAIRE
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