January 27th, 2015

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Effect of Length of Controlled Ovarian Hyperstimulation Using a Gonadotropin-Releasing Hormone Antagonist on in Vitro Fertilization Pregnancy Rates
Authors:  G. D. Royster IV, M.D., M. G. Retzloff, M.D., R. D. Robinson, M.D., J. A. King, M.D., and A. M. Propst, M.D.
  OBJECTIVE: To compare pregnancy outcomes between shorter and longer in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles using GnRH antagonist protocol.

STUDY DESIGN: Retrospective cohort analysis at a large military academic hospital. A total of 351 patients underwent 412 IVF/ICSI cycles using a GnRH antagonist protocol from September 2002 through May 2008. Clinical pregnancy and live birth rates for all IVF/ICSI cycles were compared independently for both total length of ovarian stimulation with gonadotropins (<10 days vs. ≥10 days) and GnRH antagonist use (<4 days vs. ≥4 days), respectively.

RESULTS: Clinical pregnancy rates were 54.6% among cycles with total gonadotropin use <10 days vs. 48.6% for those cycles ≥10 days, odds ratio 0.82 (0.531.27); live birth rates were 50.0% vs. 47.7%, odds ratio 0.91 (0.591.42). Clinical pregnancy rates were 54.0% among cycles with GnRH antagonist use <4 days vs. 52.8% with GnRH antagonist use ≥4 days, odds ratio 0.95 (0.621.45); live birth rates were 46.8% vs. 50.4%, odds ratio 1.15 (0.761.76).

CONCLUSION: Clinical pregnancy and live birth rates are not adversely affected by longer IVF/ICSI cycles using GnRH antagonists.
Keywords:  antagon, ganirelix acetate, gonadotropin-releasing hormone, GnRH, GnRH antagonist, in vitro fertilization
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