IVF/ICSI outcomes of the OCP plus GnRH agonist protocol versus the OCP plus GnRH antagonist fixed protocol in women with PCOS: a randomized trial

• Published in: Archives of gynecology and obstetrics 2012-09, Vol.286 (3), p.763-769
• Main Authors: Haydardedeoglu, Bulent, Kilicdag, Esra Bulgan, Parlakgumus, Ayse Huriye, Zeyneloglu, Hulusi Bulent
• Format: Article
• Language: English
• Subjects: Adult; Androstenes - administration & dosage; Clinical Protocols; Contraceptives, Oral, Combined - administration & dosage; Endocrinology; Ethinyl Estradiol - administration & dosage; Female; Gonadotropin-Releasing Hormone - agonists; Gonadotropin-Releasing Hormone - antagonists & inhibitors; Gynecology; Hormone replacement therapy; Human Genetics; Humans; Infertility, Female - drug therapy; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Ovulation Induction - methods; Polycystic Ovary Syndrome - complications; Pregnancy; Pregnancy Rate; Reproductive Medicine; Sperm Injections, Intracytoplasmic; Young Adult
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-012-2348-9

Objective To compare the IVF/ICSI outcomes of the long GnRH agonist and the fixed GnRH antagonist protocol in women with PCOS. Design Randomized controlled trial. Setting Baskent University Department of Obstetrics and Gynecology. Patients Three hundred women with PCOS. Interventions IVF/ICSI following the long GnRH agonist down-regulation or the fixed GnRH antagonist protocols. Main outcome measures Ongoing pregnancy rates. Results Ongoing pregnancy rates were 36.4 % in the OCP + GnRH agonist group and 35.9 % in the OCP + GnRH antagonist group ( p  > 0.05). Progesterone levels on the day of hCG (0.76 ± 0.71 vs. 0.58 ± 0.50), endometrial thickness on the day of hCG ( 11.57  ± 2.50 vs. 10.50 ± 2.01), total gonadotropin used (1388.71 ± 482.39 vs. 1253.25 ± 415.81), and duration of COH ( 9.07  ± 1.96 vs. 8.39 ± 1.75) were significantly lower in the OCP + GnRH antagonist group. Conclusion The OCP + long GnRH agonist and the OCP + fixed GnRH antagonist protocols yield similar ongoing pregnancy rates in women with PCOS. Although this study consisting three hundred patients, seems to be large enough in a single center, we were not able to reach to the actual size of power analysis which was approximately 3,000.