Comparison of GnRH agonist long and antagonist protocols in the same normoresponder patient undergoing assisted reproductive treatment

Amaç: Antagonist sikluslarında agonistlere göre daha düşük gebelik sonuçlarının elde edildiği öne sürülmektedir. Bu çalışma ile hem antagonist hem de agonist protokolü ile tedavisi olan bir grup normal cevaplı kadında bu iki protokolün siklus karakteristiklerinin ve tedavi sonuçlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Toplam 50 normal cevaplı kadında retrospektif karşılaştırmalı bir çalışma yapılmıştır. İlk uygulamada agonist uzun ya da antagonist protokolü ile tedavi yapılan bu 50 kadında gebelik elde edilemediğinde ya da patolojik bir gebelik termine edildiğinden 3-6 aylık bir dönemden sonra tekrar tedavi yapılmış ve ilk siklusta antagonist protokolü verilenlere agonist uzun, agonist uzun verilenlere ise antagonist protokolü verilmiştir. Aynı hastada her iki protokolün siklus karakteristikleri ve tedavi sonuçları karşılaştırılmıştır. Bulgular: Antagonist protokolünde agonist uzun protokolüne göre siklus süresi daha kısa (9.6 ve 10.9 gün; p

Yardımla üreme tedavisi uygulanan normal cevaplı kadınlarda GnRH agonist uzun ve antagonist protokollerinin karşılaştırılması

Objective: Antagonists (ANT) are suspected to yield lower pregnancy rates compared to agonist (AL) protocols. The aim of the present study was to assess cycle characteristics and outcomes of a group of normoresponder women (NR) who had undergone controlled ovarian hyperstimulation with both ANT and AL protocols for assisted reproductive treatment (ART). Materials and Methods: A retrospective comparative study was performed involving 50 NR patients. All the patients had been administered either an AL or ANT protocol at the initial attempt. Since a pregnancy could not be achieved or a pathological one was terminated, all the patients underwent a new cycle 3-6 months after the previous one, where the other protocol, unused in the first trial was employed. Stimulation characteristics and outcome of both protocols were compared in each patient. Results: Stimulation duration was shorter (9.6 vs. 10.9 days; p<0.0001), peak E2 level was lower (2527 vs. 3042 pg/ml; p=0.028) and implantation rate was higher (17.3 vs. 9.7%; p=0.049) in ANT cycles compared to AL ones. Conclusion: Antagonist protocol was observed to be as efficacious as agonist long one for superovulation of NR patients. Further studies are needed to support our belief that antagonists might be easily considered as the first choice in NR women undergoing ART.

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