Clin Exp Reprod Med.  2012 Mar;39(1):22-27. 10.5653/cerm.2012.39.1.22.

Effectiveness of GnRH antagonist multiple dose protocol applied during early and late follicular phase compared with GnRH agonist long protocol in non-obese and obese patients with polycystic ovary syndrome undergoing IVF/ICSI

• Kim CH
• Moon JW
• Kang HJ
• Ahn JW
• Kim SH
• Chae HD
• Kang BM

• KMID: 2167516
• DOI: http://doi.org/10.5653/cerm.2012.39.1.22

Abstract

OBJECTIVE
To evaluate the effectiveness of GnRH antagonist multiple dose protocol applied during early and late follicular phase (MDP-EL) in comparison with standard GnRH agonist luteal long protocol (LP) in each non-obese and obese polycystic ovary syndrome (PCOS) women undergoing IVF.
METHODS
Two hundred eleven infertile women with PCOS were recruited and randomized to undergo either GnRH antagonist MDP-EL (antagonist group) or standard GnRH agonist luteal LP (agonist group). IVF cycle outcomes were compared between the two groups.
RESULTS
Total dose and days of recombinant human follicle stimulating hormone (rhFSH) administered were significantly fewer in the antagonist group than in the agonist group. Incidence of severe ovarian hyperstimulation syndrome was significantly lower in the antagonist group. However, IVF and pregnancy outcomes were similar in the two groups. When all subjects were divided into non-obese and obese subgroups, in non-obese PCOS subgroup, IVF and pregnancy outcomes were comparable in the antagonist and agonist groups but total dose and days of rhFSH were also significantly fewer in the antagonist group. Similar findings were also observed in obese PCOS subgroup.
CONCLUSION
GnRH antagonist MDP-EL is at least as effective as GnRH agonist LP and may be a more patient-friendly alternative in controlled ovarian stimulation for PCOS patients undergoing IVF, independent of body mass index.

Keyword

Polycystic ovary syndrome; GnRH antagonist; GnRH agonist; Body mass index; Controlled ovarian stimulation; In vitro fertilization

MeSH Terms

Body Mass Index
Female
Fertilization in Vitro
Follicle Stimulating Hormone, Human
Follicular Phase
Gonadotropin-Releasing Hormone
Humans
Incidence
Ovarian Hyperstimulation Syndrome
Ovulation Induction
Polycystic Ovary Syndrome
Pregnancy
Pregnancy Outcome
Follicle Stimulating Hormone, Human
Gonadotropin-Releasing Hormone