A comparative study of GnRH antagonist and GnRH agonist in PCO patients undergoing IVF/ICSI cycles

سال انتشار: 1384
محل انتشار: International Journal of Reproductive BioMedicine، دوره: 3، شماره: 1
کد COI اختصاصی: JR_IJRM-3-1_003
زبان مقاله: انگلیسی
تعداد مشاهده: 815

نویسندگان

Assistant Professor, Department of Gynecology & Obstetrics, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Endocrinology & Female Infertility Department, Royan Institute, Tehran, Iran

Ashraf Moini

Associate Professor, Department of Gynecology & Obstetrics, Roointan-arash Maternity Hospital, Tehran University of Medical Sciences, Tehran , Iran Endocrinology & Female Infertility Department, Royan Institute, Tehran, Iran

Afsaneh Mohammadzadeh

Avesina Fertility & Infertility Research Center, Tehran, Iran

Zahra Ezabadi

Endocrinology & Female Infertility Department, Royan Institute, Tehran, Iran

چکیده

Background: Polycystic ovarian syndrome (PCOS) patients are prone to premature LH surge and ovarian hyperstimulation syndrome (OHSS). Long GnRH analogue protocol and GnRH antagonistprotocol are two methods utilized for induction ovulation in patients undergoing IVF/ICSI. Objective: The aim of this study was to compare the effects of GnRH agonists and antagonists in PCOS patients.Materials and Methods: A total of 60 PCOS patients under 35 years old were enrolled in this study. The patients have no history of thyroid disorder and hyperprolactinemia. All patientsreceived OCP (LD) before starting the treatment. Then patients randomly divided into two groups. The agonist group underwent standard long GnRH analogue protocol. In antagonist group, HMG(150 IU/day) was started from third day of cycle. Then GnRH antagonist (0.25mg) wasadministered from 6th day after HMG initiation (LH≤5 IU/ml) to the day of HCG injection.Follicular development monitored by vaginal ultra sonography and serum estradiol measurement.Results: There were no significant differences in age, duration of infertility, BMI, number of HMGampules, number of follicles≥18mm, serum estradiol level on 6th day of HMG initiation and HCG injection time, fertilization and pregnancy rate between two groups. However there were significant differences regarding duration of treatment, duration of HMG usage, LH level at the initiation of HMG, OHSS rate and number of Metaphase II oocytes between two groups (p< 0.05). Conclusion: Usage of the GnRH antagonist may have more advantages such as the shorter duration of treatment and less gonadotrophin requirement. Furthermore, the incidence of OHSS can be reduced in GnRH antagonist comparing to agonist. For decreasing the risk of OHSS and abortion rate, we recommend long term use of OCP before starting the treatment.

کلیدواژه ها

PCOS , GnRH agonist, GnRH antagonist , OHSS, IVF, ICSI

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