Pregnancy outcome in long- versus short-acting gonadotropin-releasing hormone agonist cycles in participants with normal ovarian reserve: An RCT

Background: There is no agreement on which of the ۲ gonadotropin-releasing hormone (GnRH) agonist protocols are the most efficient, neither there is any consensus on which one yields a better clinical pregnancy percentage. Objective: The present study aims to compare the effectiveness of reduced dosages of long- and short-acting GnRH agonists on pregnancy outcomes. Materials and Methods: In this randomized controlled clinical trial, ۴۰۰ women were randomly assigned to ۲ groups (n = ۲۰۰/group): the reduced dosage of long-acting GnRH agonist group (group ۱, ۱.۲۵ mg Decapeptyl) and the short-acting GnRH agonist group (group ۲, ۰.۵ mg/day Buserelin Acetate). The study was conducted at Mehr Medical Institute, Rasht, Iran between July ۲۰۱۹ and July ۲۰۲۰. Biochemical and clinical pregnancy were compared between groups. Results: No significant differences were observed in the endometrial lining, the total number of retrieved and metaphase-II oocytes, progesterone, and serum estradiol levels on human chorionic gonadotropin day, fertilization rate, and top-quality embryos between the groups. The duration of induction (۱۰.۸ ± ۱.۷ vs. ۱۰ ± ۲.۱, p < ۰.۰۰۱) and the total dosage of gonadotropins (۲۹۳۹.۴ ± ۹۴۵.۹ vs. ۲۴۴۱ ± ۱۲۴۷.۱, p < ۰.۰۰۱) were significantly greater in group ۲ than in group ۱. No significant differences were observed between the ۲ groups in terms of implantation rate, chemical pregnancy rate, and clinical pregnancy rate. A higher percentage of ovarian hyperstimulation syndrome was observed in group ۲ (p = ۰.۰۰۵). Conclusion: Due to a lower percentage of ovarian hyperstimulation syndrome in group ۱ and similar assisted reproductive technology outcomes in both groups, the long protocol was found to be superior to the short protocol.

کلیدواژه ها:

Gonadotropin-releasing hormone ، In vitro fertilization ، Pregnancy outcome ، Ovarian hyperstimulation syndrome. ، هورمون آزادکننده گنادوتروپین ، لقاح آزمایشگاهی ، نتیجه بارداری ، سندرم تحریک بیش از حد تخمدان.