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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

  • ASSISTED REPRODUCTION
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Abstract

Purpose

Embryological and clinical efficacy of gonadotropin-releasing 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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Acknowledgement

Financial support—grant number KBN 2 P05E 034 28 from State Committee for Scientific Research

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Authors and Affiliations

  1. Department of Reproductive Medicine and Gynecology, Pomeranian Medical University, 2 Siedlecka Street, Szczecin-Police, 72-010, Poland

    Rafal Kurzawa, Przemyslaw Ciepiela & Tomasz Baczkowski

  2. Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 72 al. Powstancow Wlkp. Street, Szczecin, 70-111, Poland

    Krzysztof Safranow

  3. Glan Clwyd Hospital, Conwy and Denbighshire NHS Trust, Rhyl, Benbighshire, LL18 5UJ, UK

    Pawel Brelik

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  1. Rafal Kurzawa
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  2. Przemyslaw Ciepiela
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  3. Tomasz Baczkowski
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  4. Krzysztof Safranow
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  5. Pawel Brelik
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Correspondence to Przemyslaw Ciepiela.

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Capsule GnRH antagonist and agonist protocols in non-obese PCOS patients yield similar embryological and clinical outcomes. GnRH antagonist protocols may be financially and clinically attractive for patients undergoing IVF.

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Kurzawa, R., Ciepiela, P., Baczkowski, T. et al. 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. J Assist Reprod Genet 25, 365–374 (2008). https://doi.org/10.1007/s10815-008-9249-7

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  • DOI: https://doi.org/10.1007/s10815-008-9249-7

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