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GnRH Antagonist Protocol: Is It Optimal for All Patients of Different Ages Undergoing In Vitro Fertilization and Embryo Transfer?

DOI: 10.4236/asm.2017.74012, PP. 153-160

Keywords: GnRH Agonist, GnRH Antagonist, IVF-ET

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Abstract:

Background: To assess the effect of these two protocols in patients of different ages. Methods: 1923 in vitro fertilization and embryo transfer (IVF-ET) cycles were divided into two groups: a GnRH-ant protocol group and GnRH-a long protocol group, and then every group were subdivided into four age ranges. The general materials and IVF outcomes were compared. Results: The incidence of OHSS fluctuated from 0% to 2.37% with GnRH-ant protocol, which was significantly lower than another (P < 0.05). Of all age ranges, the implantation and clinical pregnancy rates with GnRH-ant protocol were all lower than those with GnRH-a protocol. When the age was less than 35 years old, the CPRs in GnRH-ant protocol group were significantly lower than in another group (45.56% vs. 62.29%, 46.07% vs. 55.59%, respectively; P < 0.05). Conclusion: The antagonist protocol should be considered in patients with a high ovarian response (e.g., PCOS patients) to avoid OHSS. Older patients (>35 years) could be treated with the antagonist protocol.

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