Comparison of GnRH agonists and antagonists in unselected IVF/ICSI patients treated with different controlled ovarian hyperstimulation protocols:: a matched study

Objectives: To evaluate the results of the use of GnRH antagonist (GnRHant) and GnRH analog (GnRHa) in two matched group, of unselected IVF/ICSI patients in a retrospective matched pair analysis. Study design: Patients (n = 52) were stimulated with human menopausal gonadotropin (hMG) and/or recombinant FSH (rFSH). In Group I (n = 26) a daily dose of 0.25 mg of Cetrorelix(R) (GnRHant) was administered when follicles reached a diameter of greater than or equal to 14 mm. Patients in Group 11 (n = 26) were first desensitized with GnRHa triptorelin long protocol, which was continued during the gonadotropins treatment until the induction of ovulation. Results: In both groups, serum LH levels remained low during the stimulation. The mean length of stimulation, and the dose of FSH required per patient were similar in both groups. The mean E2 level on day of hCG administration was significantly higher in the patients of Group 11 (2076 1430 versus 1145 +/- 605 pg/ml), however, a progressive increase in serum E2 concentration during the cycle was noted in both groups. A median of 5.38 and 6.34 mature oocytes per patient was obtained. and the fertilization rate was 59.3% in Group I and 63.6% in Group II. Pregnancy rate (PR) were better in Group 11 (15 versus 5%). and no severe or moderate ovarian hyperstimulation syndrome (OHSS) occurred. Conclusions: GnRHant and GnRHa provide comparable results in unselected patients, while GnRHant allows a higher flexibility in the treatment. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.