Comparison GnRH agonist short protocol and GnRH antagonist in Brazilian normoresponder patients undergoing their first cycle of controlled ovarian stimulation
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2013-10
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Objective: to evaluate the results of gonadotropin-rele-
asing hormone agonist (GnRH-ag) and gonadotropin-
-releasing hormone antagonist (GnRH-ant) using daily
dose fixed of rFSH, in Brazilian normoresponder patients
undergoing their first in vitro fertilization or intracyto-
plasmic sperm injection (IVF/ICSI) cycle.
methods: a total 50 women were included in this retros-
pective comparative study. Patients were stimulated with
standard 150 IU/day recombinant FSH (follitropin alfa).
In group GnRH-ag a daily dose of leuprolide acetate (1
mg short protocol) was administered starting on day 1 of
the cycle till the day of hCG injection. In GnRH-ant group
a daily dose of cetrorelix acetate (0.25 mg) was administered when follicles reached a diameter of >- 14mm. Recombinant human chorionic gonadotropin (250 μg
rhCG) was administered when at least three follicles of
18 mm in diameter were observed. Stimulation charac-
teristics and outcome of both protocols were compared.
Results: stimulation days with rFSH (11.0 vs. 9.24;
p=0.0091), total doses of rFSH (2094 vs. 1365 IU;
p<0.0001), GnRH using days (12.0 vs. 3.6; p<0.0001),
and total doses of GnRH (1.2 vs. 0.9 mg; p=0.0001)
was shorter in GnRH-antagonist group. The number of follicles (>-16mm) on day rhCG (6.76 vs. 4.64; =0.04) was higher in GnRH-ag group. There was no difference in
the other parameters, nevertheless, the number oocytes
retrieved (5.92 vs. 4.16; p=0.06) was higher in GnRH-
-agonist group, but the fertilization rate (40.1 vs. 54.4
%; p=0.29) was higher in GnRH-antagonist group. The
rates of chemical and clinical pregnancy were similar in
two groups.
Conclusion: controlled ovarian stimulation plays a
major role in human reproduction and, it is well known
that, even in normoresponders patients, the first treat-
ment cycle exposes patients to a risk of either a low or
an excessive ovarian response. In this study GnRH-ag
and GnRH-ant provide comparable results, but antago-
nist protocol was shorter period of stimulation.
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GnRH agonist, Infertility, GnRH antagonist, Normal ovarian response, Agonista GnRH, Infertilidad, Antagonista GnRH, Respuesta ovárica normal
Citação
ARRUDA, Jalsi Tacon et al. Comparison GnRH antagonist short protocol and GnRH antagonist in brazilian normoresponders patients undergoing their first cycle of controlled ovarian stimulation. Jornal Brasileiro de Reprodução Assistida, Brasília, DF, v. 17, n. 5, p. 304-309, Sept./Oct. 2013.