Normal over rezervine sahip infertil hastalarda IVF-ICSI-ET sikluslarında GnRH agonist uzun protokol ile GnRH antagonist protokolün karşılaştırılması
Amaç: Bu çalışmada normal over
rezervine sahip infertil hastalarda rekombinant FSH kullanılarak kontrollü
overyan stimülasyon yapılan IVF-ICSI-ET sikluslarında, GnRH agonist uzun
protokol ile fleksible multidoz GnRH antagonist protokolü karşılaştırmayı
amaçlanmıştır.. Gereç ve Yöntem:
Çalışmamızda, kontrollü over stimülasyonu için rekombinant FSH kullanılmış ve
sonrasında IVF-ICSI-ET uygulanmış 1765 hastanın dosyaları retrospektif olarak
taranarak kullanıldı. Belirlenen kriterlere uyan 121 GnRH agonist uzun protokol
ve 53 fleksible multidoz GnRH antagonist protokol uygulanan hasta olmak üzere,
toplamda 174 hasta çalışmaya dahil edildi. İki grup arasındaki stimülasyon
sürelerinin, FSH dozlarının, elde edilen oosit sayısı, fertilizasyon
oranlarının, implantasyon oranlarının, hCG pozitiflik oranlarının, klinik
gebelik oranlarının ve eve giden bebek oranlarının karşılaştırılması yapıldı.Bulgular: Çalışmaya alınan
hastalardan GnRH antagonist protokolde kullanılan ortalama toplam stimülasyon
süresi 8.57 ± 1.26 gün iken, GnRH agonist grupta 9.47 ± 1.56 gün olarak
bulundu. HCG pozitiflik oranları GnRH antagonist grupta %35.8 iken, GnRH
agonist grupta %34.7 bulunmuştur. Eve giden bebek oranları GnRH antagonist
protokolde %28.25 iken, GnRH agonist long protokolde %27.3 bulunmuştur.
Sonuç: Fleksible
multidoz GnRH antagonist protokolünde, stimülasyon süresi daha kısa ve FSH dozu
daha azdır. Bununla beraber, GnRH agonist uzun protokol ile benzer başarı
oranlarına sahip olduğu söylenebilir.
Comparison between GnRH agonist long protocol and GnRH antagonist protocol in IVF-ICSI-ET cycles of normal ovarian reserve infertile patients
Purpose: The aim of this
study was to compare GnRH agonist long protocol and flexible multidose GnRH
antagonist protocol for infertile patients with normal ovarian reserve in
IVF-ICSI-ET cycles, on which controlled ovarian stimulation was carried out by
using recombinant FSH.Material and Methods: Medical files belonging to 1765 patients who were subjected to
controlled ovarian stimulation by using recombinant FSH and afterwards to
IVF-ICSI-ET were retrospectively analyzed. A total of 174 patients, 121 with
GnRH agonist long protocol and 53 with flexible multidose GnRH antagonist
protocol were included in the study. Stimulation periods, total doses of used
FSH, obtained oocyte counts, fertilization rates, implantation rates, average
values of hCG positive rates, clinic pregnancy and discharged newborn rates
were compared between the two groups.Results: Average of
total stimulation time for GnRH antagonist protocol group was found to be
8.57±1.26 days, while it was 9.47±1.56 for the GnRG agonist group. HCG positive
rates were 35.8% and 34.7% for the GnRH antagonist group and GnRH agonist group
respectively. Rates of newborns discharged to home was 28.25% for GnRH
antagonist protocol and 27.3% in th other.
Conclusion: Flexible
multidose GnRH antagonist protocol provided shorter stimulation period and
required less average total FSH dose when compared with the GnRH agonist long
protocol. Besides flexible multidose GnRH antagonist protocol can be said to
provide similar effectiveness with the GnRH agonist long protocol.
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