Mini-dose GnRH-a long versus short protocol in patients 35 years old undergoing in vitro fertilization

• Published in: Gynecological endocrinology 2014-07, Vol.30 (7), p.498-501
• Main Authors: Xu, Hai-Jing, Ji, Xiao-Wei, Hong, Yan, Zhu, Qin-Ling, Zhao, Xiao-Ming, Sun, Yun
• Format: Article
• Language: English
• Subjects: Adult; Advanced reproductive age; Age Factors; Endometrium - diagnostic imaging; Endometrium - physiology; Estradiol - blood; Female; GnRH agonist; Gonadotropin-Releasing Hormone - agonists; Humans; in vitro fertilization; Infant, Newborn; Infertility, Female - drug therapy; Infertility, Female - therapy; Live Birth; long protocol; Luteinizing Hormone - blood; mini-dose; Oocyte Retrieval; Ovarian Follicle - diagnostic imaging; Ovarian Follicle - drug effects; Ovarian Follicle - physiology; Ovulation Induction - methods; Pregnancy; Retrospective Studies; short protocol; Triptorelin Pamoate - administration & dosage; Ultrasonography
• ISSN: 0951-3590; 1473-0766
• DOI: 10.3109/09513590.2014.906570

Abstract Purpose: To compare the clinical result of mini-dose GnRH-a long protocol with short protocol in older patients undergoing IVF. Materials and methods: This was a retrospective study. Four hundred and sixty-one women aged above 35-year-old in first cycle were assigned to two groups: GnRH-a short protocol (n = 359); and mini-dose GnRH-a long protocol (n = 102). Both groups were divided based on their age, into groups over and under 38 years old. Primary outcome include live birth rate per started cycle. Other clinical outcomes were good-quality embryo rate, clinical pregnancy rate. Results: Patients treated with mini-dose GnRH-a protocol and those treated with short protocol showed similar live birth rate. In the mini-dose long protocol group aged 35-38 years old, patients showed significantly thicker endometrium at the day of hCG administration, higher number of good embryos obtained and higher good-quality embryo rate (56.3% versus 46.5%) compared with short protocol. The implantation rate and clinical pregnancy rate were higher versus short protocol group, but this result was not statistically significant. Conclusion(s): Mini-dose GnRH-a long protocol for older women is at least as effective as short protocol, especially in patients aged 35-38 years, with a better good-quality embryo rate and higher number of good embryos obtained, therefore mini-dose GnRH-a long protocol can be considered as an alternative protocol for patients above 35 years age.