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Comparison between GnRH Antagonist and Agonist Long Protocols in Poor Responders  

Choi, Ji-Young (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Ku, Seung-Yup (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Kim, Hoon (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Jee, Byung-Chul (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Suh, Chang-Suk (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Kim, Seok-Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Choi, Young-Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Kim, Jung-Gu (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Moon, Shin-Yong (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
Publication Information
Clinical and Experimental Reproductive Medicine / v.37, no.3, 2010 , pp. 239-244 More about this Journal
Abstract
Objective: The objective of this retrospective study was to compare the in vitro fertilization (IVF) outcomes of gonadotropinreleasing hormone (GnRH) agonist and GnRH antagonist protocols in poor responders. Methods: A total of 172 cycles in subjects with less than 5 oocytes retrieved treated with either GnRH agonist long protocols or antagonist protocols were included. The outcome variables such as numbers of growing follicles and retrieved oocytes, and the fertilization rate were evaluated as the main outcome measures. Results: There was no difference in regard to the numbers of growing follicles and oocytes, and fertilization rate between the two groups. $E_2$ level on Day 7/8, mean gonadotropin dose, and the days of stimulation were shown to be statistically different (p<0.01, respectively). Conclusion: Considering that similar results were observed with less time and gonadotropin dose, GnRH antagonist protocol may be considered as a preferable choice over GnRH agonist protocols in poor responders.
Keywords
Poor responder; Gonadotropin-releasing hormone agonist; GnRH antagonist; Controlled ovarian hyperstimulation; in vitro fertilization;
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1 choolcraft WB. Evaluation and treatment of the poor responder. Clin Obstet Gynecol 2006; 49: 23-33.   DOI   ScienceOn
2 Frattarelli JL, Bergh PA, Drews MR, Sharara FI, Scott RT. Evaluation of basal estradiol levels in assisted reproductive technology cycles. Fertil Steril 2000; 74: 518-24.   DOI   ScienceOn
3 van Rooij IA, Broekmans FJ, te Velde ER, Fauser BC, Bancsi LF, de Jong FH, et al. Serum anti-Mullerian hormone levels: a novel measure of ovarian reserve. Hum Reprod 2002; 17: 3065-71.   DOI   ScienceOn
4 Seifer DB, Maclaughlin DT. Mullerian Inhibiting Substance is an ovarian growth factor of emerging clinical significance. Fertil Steril 2007; 88: 539-46.   DOI   ScienceOn
5 Lin Y, Kahn JA, Hillensjo T. Is there a difference in the function of granulosa-luteal cells in patients undergoing invitro fertilization either with gonadotrophin-releasing hormone agonist or gonadotrophin-releasing hormone antagonist? Hum Reprod 1999; 14: 885-8.   DOI   ScienceOn
6 arci R, Caserta D, Dolo V, Tatone C, Pavan A, Moscarini M. GnRH antagonist in IVF poor-responder patients: results of a randomized trial. Reprod Biomed Online 2005; 11: 189-93.   DOI   ScienceOn
7 Turhan NO. Poor response-the devil is in the definition. Fertil Steril 2006; 86: 777.
8 hang MY, Chiang CH, Hsieh TT, Soong YK, Hsu KH. Use of the antral follicle count to predict the outcome of assisted reproductive technologies. Fertil Steril 1998; 69: 505-10.   DOI   ScienceOn
9 Gonen Y, Jacobson W, Casper RF. Gonadotropin suppression with oral contraceptives before in vitro fertilization. Fertil Steril 1990; 53: 282-7.   DOI
10 Loutradis D, Drakakis P, Kallianidis K, Milingos S, Dendrinos S, Michalas S. Oocyte morphology correlates with embryo quality and pregnancy rate after intracytoplasmic sperm injection. Fertil Steril 1999; 72: 240-4.   DOI   ScienceOn
11 Seifer DB, Lambert-Messerlian G, Hogan JW, Gardiner AC, Blazar AS, Berk CA. Day 3 serum inhibin-B is predictive of assisted reproductive technologies outcome. Fertil Steril 1997; 67: 110-4.   DOI   ScienceOn
12 Borm G, Mannaerts B. Treatment with the gonadotrophinreleasing hormone antagonist ganirelix in women undergoing ovarian stimulation with recombinant follicle stimulating hormone is effective, safe and convenient: results of a controlled, randomized, multicentre trial. The European Orgalutran Study Group. Hum Reprod 2000; 15: 1490-8.   DOI   ScienceOn
13 Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, et al. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertil Steril 2000; 73: 314-20.   DOI   ScienceOn
14 Syrop CH, Willhoite A, Van Voorhis BJ. Ovarian volume: a novel outcome predictor for assisted reproduction. Fertil Steril 1995; 64: 1167-71.   DOI
15 Toner JP, Philput CB, Jones GS, Muasher SJ. Basal folliclestimulating hormone level is a better predictor of in vitro fertilization performance than age. Fertil Steril 1991; 55: 784-91.   DOI
16 European and Middle East Orgalutran Study Group. Comparable clinical outcome using the GnRH antagonist ganirelix or a long protocol of the GnRH agonist triptorelin for the prevention of premature LH surges in women undergoing ovarian stimulation. Hum Reprod 2001; 16: 644-51.   DOI   ScienceOn