May 29th, 2022

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Title:
GnRH Agonist Long Protocol vs. a Single 3-mg GnRH Antagonist: A Comparison of 2 Protocols for Pituitary Down-Regulation in Oocyte Donor-Controlled Ovarian Hyperstimulation Cycles
Authors:  Teresa M. Erb, M.D., and Anthony N. G. Wakim, M.D.
  OBJECTIVE: To compare ovarian stimulation outcomes for 2 protocols of pituitary down-regulation in a group of fertile women.

STUDY DESIGN: Retrospective outcome analysis of 35 healthy oocyte donors participating in a university-
affiliated in vitro fertilization donor program from 1999 to 2004. Consecutive donor cycles were grouped according to the agent used for down-regulation (n=27 GnRH agonist, n=31 GnRH antagonist). Statistical analysis was performed using ANOVA, c2 and Wilcoxon Rank Sum tests.

RESULTS: Neither gonadotropin dosage, days of stimulation or number of oocytes retrieved per treatment cycle were statistically different between groups. The only
significant embryo quality parameter was more grade D embryos in the GnRH antagonist (0.4±0.6) vs. GnRH agonist arm (0.0±0.2). The number of embryos transferred was significantly greater for the GnRH agonist (2.7±0.5) than GnRH antagonist arm (1.0±0.5), whereas implantation and clinical pregnancy rates were not significantly different between groups. No patient experienced the ovarian hyperstimulation syndrome.

CONCLUSION: Since there was no significant difference in the biologic effects of the 2 protocols, the use of a 3-mg GnRH antagonist for down-regulation in a donor program is preferable to the long protocol because it requires only 1-2 injections for pituitary down-regulation. (J Reprod Med 2008;53: 331-337)
Keywords:  assisted reproductive techniques, GnRH agonists, GnRH antagonists, gonadotropins, oocyte donation
   
   
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