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Gonadotropin-Releasing Hormone (GnRH)-Antagonist Versus GnRH-Agonist in Ovarian Stimulation of Poor Responders Undergoing IVF

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Abstract

Purpose : The objective of this study was to compare the efficacy of GnRH-antagonists to GnRH-agonists in ovarian stimulation of poor responders undergoing IVF.

Methods : Retrospective analysis of our data revealed that 56 patients underwent treatment with a GnRH-agonist according to the flare-up protocol. Patients failing to achieve an ongoing pregnancy (n=53) were subsequently treated in the next cycle with a GnRH-antagonist according to the multiple-dose protocol. Main outcome measures included the clinical pregnancy and implantation rates.

Results : While ovulation induction characteristics and results did not differ between the two protocols, the number of embryos transferred was significantly higher (P=0.046) in the GnRH-antagonist than in the GnRH-agonist stimulation protocol (2.5 ± 1.6 vs. 2.0 ± 1.4, respectively). The clinical pregnancy and implantation rates per transfer in the GnRH-antagonist group appeared higher than in the GnRH-agonist, but did not differ statistically (26.1 and 10.7 compared with 12.2 and 5.9%, respectively). However, the ongoing pregnancy rate per transfer was statistically significantly higher (P=0.03) in the GnRH-antagonist than in the GnRH-agonist group (23.9 vs. 7.3%, respectively).

Conclusion : Applying GnRH-antagonists to ovarian stimulation protocols may offer new hope for IVF poor responder patients. However, further controlled randomized prospective studies with larger sample sizes are required to establish these results.

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Authors and Affiliations

  1. IVF Unit, Department of Obstetrics and Gynecology, Hebrew University–Hadassah Medical Center, Ein Kerem, P.O. Box 12000, 91120, Jerusalem, Israel

    Sozos J. Fasouliotis, Neri Laufer, Aby Lewin & Alex Simon

  2. IVF Unit, Department of Obstetrics and Gynecology, Hebrew University–Hadassah Medical Center, Mount Scopus, Jerusalem, Israel

    Shelley Sabbagh-Ehrlich & Arye Hurwitz

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  1. Sozos J. Fasouliotis
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  2. Neri Laufer
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  3. Shelley Sabbagh-Ehrlich
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  4. Aby Lewin
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  5. Arye Hurwitz
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Fasouliotis, S.J., Laufer, N., Sabbagh-Ehrlich, S. et al. Gonadotropin-Releasing Hormone (GnRH)-Antagonist Versus GnRH-Agonist in Ovarian Stimulation of Poor Responders Undergoing IVF. J Assist Reprod Genet 20, 455–460 (2003). https://doi.org/10.1023/B:JARG.0000006707.88826.e7

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  • DOI: https://doi.org/10.1023/B:JARG.0000006707.88826.e7

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