CHSJ

Curr Health Sci J, vol. 39, no. 1, 2013

GnRH Antagonist IVF Protocol in PCOS

[Original Paper]

A. ONOFRIESCU(1), A. BORS(2), A. LUCA(3), M. HOLICOV(3), M. ONOFRIESCU(3), C. VULPOI(4)


(1)Department of Diabetology, University of Medicine and Pharmacy of Iasi;
(2)Fertility Reproductive Medical Center Omini Clinic Iasi;
(3)Department of Obstetrics and-Gynecology, University of Medicine and Pharmacy of Iasi,
(4)Department of Endocrinology, University of Medicine and Pharmacy of Iasi


Abstract:

Objective. The aim of the present study was to compare the GnRH agonist long protocol with the flexible GnRH antagonist protocol in infertile PCOS women undergoing COS in terms of clinical pregnancy rate (CPR), with special reference to the incidence of OHSS. Materials and Methods. The study was conducted at the Hospital Obstetrics and Gynecology Cuza Voda Iasi and Fertility Reproductive Medical Center Omini Clinic Iasi from June 1, 2010, to September 31, 2012. PCOS as defined by the Rotterdam 2003 consensus, i.e. presence of two of the following three features: presence of oligo- and/ or anovulation, clinical and/or biochemical signs of hyperandrogenism, polycystic ovaries and exclusion of other endocrinopathies. Results. No differences were observed in clinical pregnancy rate (CPR) in the agonist and antagonist protocols, respectively. Incidence of OHSS was lower in the antagonist compared with agonist group (4% versus 28%). Duration of stimulation (13,80 + 1,4 vs 11,85 + 2,4 p < 0,001) and total gonadotrophin required (2435,5 + 884,5 versus 2005, 5 + 545,5 IU p < 0.003) were also lower in the antagonist compared with agonist protocol. Conclusions. The current study suggests that the flexible GnRH antagonist protocol is associated with a similar ongoing pregnancy rate, lower incidence of OHSS grade II, lower gonadotrophin requirement and shorter duration of stimulation, compared with GnRH agonist. The GnRH antagonist might be the treatment choice for patients with PCOS undergoing IVF.


Keywords: polycystic ovary syndrome, GnRH antagonist, infertility



Corresponding: Alina Onofriescu, MD, PhD Student, Department of Diabetology, University of University of Medicine and Pharmacy of Iasi , 16 Universitatii Street, 700115, Iasi, Romania, amarige_u82@yahoo.com


DOI 10.12865/CHSJ.39.01.03 - Download PDF
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