May 29th, 2022

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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 (0.40.6) vs. GnRH agonist arm (0.00.2). The number of embryos transferred was significantly greater for the GnRH agonist (2.70.5) than GnRH antagonist arm (1.00.5), 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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