The Ideal Stimulation Protocol: Is There One?

Comparison of the Long-Acting GnRH Agonist Follicular Protocol with the GnRH Antagonist Protocol in Women Undergoing In Vitro Fertilization: A Systematic Review and Meta-analysis

“…Long-acting GnRH agonist protocols, which enable maximum ovarian stimulation, have been the standard IVF protocol since decades [24]. The long-acting GnRH agonist protocol has advantages over the GnRH antagonist, primarily by complete elimination of the fluctuation in preovulatory LH levels during the course of ovarian hyperstimulation [1]. A decreased probability of pregnancy due to the increased incidence of LH instability in the GnRH antagonist cycles has been evaluated by many studies [25][26][27].…”

“…It is well documented that administration of exogeneous GnRH agonists or GnRH antagonist for ovarian stimulation in IVF can lead to OHSS [ 1 ]. A substantial amount of evidence suggests that the GnRH antagonist protocol decreases the risk of OHSS in patients undergoing [ 21 ].…”

“…The gonadotropin-releasing hormone (GnRH) agonist and the GnRH antagonist protocols are well-established methods for controlled ovarian hyperstimulation among patients who are undergoing assisted reproductive technology (ART) [ 1 ]. Since the advent of GnRH agonists in the 1980s to prevent premature luteinizing hormone (LH) outpouring, thereby increasing the number of retrieved oocytes and pregnancy rates, GnRH agonist protocols have become the gold standard for in vitro fertilization (IVF) [ 2 , 3 ].…”

“…Another study reported equivalent live birth rate with both protocols [ 11 ]. The best protocol for IVF is widely debated in the literature and the optimal protocol remains inconclusive because of several confounders including variation in study population, variation in treatment arms apart from agonist and antagonists, and variation in stimulation strategies [ 1 ]. In China, different GnRH agonist protocols are used flexibly and long-acting GnRH agonist follicular protocols have been used in increasing number of IVF centers in recent years.…”

Functionality of a novel follitropin alfa pen injector: results from human factor interactions by patients and nurses

“…Thus, based on ovarian reserve measurements, each subgroup of patients, e.g. normal, poor, or hyperresponders, will be treated using a protocol tailored to her own needs [6].…”