A comparative study between the outcomes of the gonadotropin releasing hormone agonist and the gonadotropin releasing hormone antagonist protocols for superovulation in polycystic ovarian disease patients undergoing ICSI cycles

Abstract EN

Background: Polycystic ovarian syndrome (PCOS) patients are prone to premature LH surge and ovarian hyperstimulation syndrome (OHSS).

Long GnRH analogue protocol and GnRH antagonist protocol are two methods utilized for induction ovulation in patients undergoing ICSI.

Objective: The aim of this study is to evaluating the outcomes of intra-cytoplasm sperm injection (ICSI) utilization of gonadotropin-releasing hormone (GnRH) antagonists for ovarian stimulation in polycystic ovarian syndrome (PCOS) patients compared with classic luteal long agonist protocols.

Design: Interventional, preventive randomized, comparative case study.

Place & time of study: ART unit Al-Azhar University.

In the period from April 2013 to April 2015.

Patient(s) and Interventions: PCOS patients undergoing ICSI including 200 women who underwent long agonist protocols and 200 women who underwent GnRH antagonist protocols.

Main Outcome Measure(s): Chemical pregnancy rate (CPR) which is defined as pregnancy that is confirmed by detecting Beta Human Chorionic Gonadotropins in serum, ovarian hyperstimulation syndrome (OHSS) rate, cancellation rate, dose of gonadotrophins (rFSH), duration of stimulation (stimulation days), and E2 serum level at day of HCG.

Result(s): There were no statistical significant differences as regarding age, BMI, and basal hormonal profile which included serum level of FSH, LH, and E2, No.

of oocyte retrieved, Fertilization rate, No.

of ET, Cancellation rate, and Chemical pregnancy rate.

However there were significant differences regarding number of rFSH ampoules (total dose of stim), duration of treatment, E2 at day of HCG, and incidence of OHSS.

Conclusion(s): With respect of all studies, a GnRH antagonist protocol is similar to a GnRH agonist long protocol.

However, for severe OHSS, a GnRH antagonist protocol is better in PCOS patients.