Comparação entre dois protocolos para estimulação ovariana com agonista/antagonista do hormônio liberador de gonadotrofinas (GnRH) em mulheres submetidas ao primeiro ciclo de reprodução assistida
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Data
2013-07-01
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Universidade Federal de Goiás
Resumo
Infertility affects more couples and assisted reproduction techniques offer a
possibility of treatment and the chance of having a child. Thus, the first attempt to
ovulation induction is critical to the success of the cycle or even for future attempts
is successful. Objective: To compare the protocols using GnRH agonist or
antagonist for ovarian stimulation in normo-responders undergoing the first cycle
of IVF/ICSI. Methods: we conducted a literature review on the history of ovulation
induction controlled by medications. From the data available in the database of
electronic medical records SISFERT used in the Laboratory of Human
Reproduction (LabRep-HC-FM-UFG) a comparative retrospective observational
study was conducted with 50 patients divided into two groups according to
protocol: GnRH-agonist (leuprolide acetate 1 mg/day short protocol) or GnRHantagonist
(Cetrorelix 0.25 mg/day), which received 150 IU/day of rFSH (follitropin
alpha) and 250 µg of rhCG (alpha-coriogonadotrofina) in both groups. Results:
Statistically significant differences were observed in the days of stimulation with
rFSH, total dose of gonadotropin, days of use of GnRH, GnRH dose and total
number of follicles (≥ 16 mm) on the day of the group rhCG GnRH agonist. There
was no significant difference in other parameters, however, the number of oocytes
retrieved was slightly higher in the GnRH agonist, but fertilization rate was higher
in the GnRH-antagonist. Pregnancy rates and clinical chemistry were similar in
both groups. Conclusions: although no significant differences in the results
analyzed, the use of flexible antagonist protocol facilitates the handling and
enables the patient using much lower doses of gonadotropins itself as the
antagonist, reducing the cost of treatment when compared to the protocol with
GnRH agonist.
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ARRUDA, Jalsi Tacon. Comparação entre dois protocolos para estimulação ovariana com agonista/antagonista do hormônio liberador de gonadotrofinas (GnRH) em mulheres submetidas ao primeiro ciclo de reprodução assistida. 2013. 86 f. Tese (Doutorado em Ciências da Saúde) - Universidade Federal de Goiás, Goiânia, 2013.