Comparing GnRH agonist long protocol and gnrh antagonist protocol in outcome the first cycle of ART

Abstract

GnRH-antagonist is an effective, safe, and well-tolerated alternative to agonist in the first cycle of ART.

Comparisons of GnRH Antagonist versus GnRH Agonist Protocol in Supposed Normal Ovarian Responders Undergoing IVF: A Systematic Review and Meta-Analysis

“…This outcome measure was evaluated in 15 studies [8]–[12], [15]–[19], [21], [24]–[26], [28] (2,807 cases; the unified international standard unit pg/ml was adopted, with a conversion factor of 3.67), and heterogeneity was observed among various trials ( P <0.00001, I 2  = 96%). Therefore, a random-effect model was used for the meta-analysis.…”

Comparison GnRH agonist short protocol and GnRH antagonist in Brazilian normoresponder patients undergoing their first cycle of controlled ovarian stimulation

“…Current consensus is that a higher dose leads to the retrieval of more oocytes but similar pregnancy rates in standard patients (younger than 40 years of age, having two ovaries, a normal menstrual cycle and a normal basal FSH level) (Fauser et al, 2008;Hayden, 2008). Firouzabadi et al, (2010) recommended dose of rFSH was 100 to 250 IU/day in the agonist protocol and 150 or 200 IU/day in the GnRH antagonist cycles. Kolibianakis et al, (2006) propose that the stimulation duration was shorter and there was less usage of rFSH used GnRH antagonist protocol as an advantage when compared with agonist treatment, and Huang et al, (2011) showed some advantages of the GnRH antagonist protocol.…”

“…Consequently, GnRH-ant reduces the dosage and length of the exogenous gonadotropin treatment. Comparative studies between the two analogues have suggested that the use of antagonists is associated with a shorter duration of the ovulatory stimulus and a decreased incidence of ovarian hyperstimulation syndrome (OHSS); however, the rates of pregnancy and live birth do not appear to be significantly affected, depending on the type of GnRH analogue used (Fauser et al, 2008;Hayden, 2008;Firouzabadi et al, 2010;Griesinger et al, 2010;Pu et al, 2011;Maldonado et al, 2013;Orvieto & Patrizio, 2013). Multiple follicular development is achieved by extending the period during which the concentration of FSH remains above the FSH threshold necessary to stimulate single-follicular growth.…”

“…Multiple follicular development is achieved by extending the period during which the concentration of FSH remains above the FSH threshold necessary to stimulate single-follicular growth. Studies about pharmacology have suggesting that the time lag between FSH administration and follicular growth was at least 4 days long (Yong et al, 2003;Xavier et al, 2005;Hsieh et al, 2008;Aygum & Kahraman, 2010;Firouzabadi et al, 2010). Daily Fixed doses protocols of gonadotropins to compare efficacy of treatment like length, the total dose of gonadotropins, as well as the number of oocytes recovered are pitfalls because frequently are necessary to adjust doses during treatment.…”

Role of natural killer cells in reproductive failure

“…Одни авторы в его основу закладывают количество неэффективных циклов ВРТ (2 и более; 3 и бо-лее) [3][4][5], другие -дополняют информацией о количестве и качестве перенесенных эмбри-онов [6]. Например, 8 эмбрионов на стадии дробления или 4 -на стадии бластоцисты в 2-6 циклах ЭКО [7]. По мнению профессора L. Polanski (2014), повторные неудачи ВРТ -это отсутствие имплантации, определяемой по уровню ХГЧ в сыворотке крови на 14-й день после переноса эмбрионов хорошего качества, в двух и более последовательных циклах ЭКО.…”