scholarly journals GnRH agonist versus GnRH antagonist in ovarian stimulation: has the ongoing debate resolved?

2014 ◽  
Vol 29 (5) ◽  
pp. 647-649 ◽  
Author(s):  
Raoul Orvieto
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Ongoing Debate

GnRH agonist versus GnRH antagonist in ovarian stimulation: the role of elevated peak serum progesterone levels

2013 ◽  
Vol 29 (9) ◽  
pp. 843-845 ◽  
Author(s):  
Raoul Orvieto ◽  
Ravit Nahum ◽  
Simion Meltzer ◽  
Gadi Liberty ◽  
Eyal Y. Anteby ◽  
...  
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Peak Serum ◽  
Serum Progesterone

scholarly journals Progestin primed ovarian stimulation using corifollitropin alfa in PCOS women effectively prevents LH surge and reduces injection burden compared to GnRH antagonist protocol

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Chi Huang ◽  
Mei-Zen Huang ◽  
Kok-Min Seow ◽  
Ih-Jane Yang ◽  
Song-Po Pan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Polycystic Ovary ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Lh Surge ◽  
Corifollitropin Alfa ◽  
Premature Lh Surge

AbstractUtilizing corifollitropin alfa in GnRH antagonist (GnRHant) protocol in conjunction with GnRH agonist trigger/freeze-all strategy (corifollitropin alfa/GnRHant protocol) was reported to have satisfactory outcomes in women with polycystic ovary syndrome (PCOS). Although lessening in gonadotropin injections, GnRHant were still needed. In addition to using corifollitropin alfa, GnRHant was replaced with an oral progestin as in progestin primed ovarian stimulation (PPOS) to further reduce the injection burden in this study. We try to investigate whether this regimen (corifollitropin alfa/PPOS protocol) could effectively reduce GnRHant injections and prevent premature LH surge in PCOS patients undergoing IVF/ICSI cycles. This is a retrospective cohort study recruiting 333 women with PCOS, with body weight between 50 and 70 kg, undergoing first IVF/ICSI cycle between August 2015 and July 2018. We used corifollitropin alfa/GnRHant protocol prior to Jan 2017 (n = 160), then changed to corifollitropin alfa/PPOS protocol (n = 173). All patients received corifollitropin alfa 100 μg on menstruation day 2/3 (S1). Additional rFSH was administered daily from S8. In corifollitropin alfa/GnRHant group, cetrorelix 0.25 mg/day was administered from S5 till the trigger day. In corifollitropin alfa/PPOS group, dydrogesterone 20 mg/day was given from S1 till the trigger day. GnRH agonist was used to trigger maturation of oocyte. All good quality day 5/6 embryos were frozen, and frozen-thawed embryo transfer (FET) was performed on subsequent cycle. A comparison of clinical outcomes was made between the two protocols. The primary endpoint was the incidence of premature LH surge and none of the patients occurred. Dydrogesterone successfully replace GnRHant to block LH surge while an average of 6.8 days of GnRHant injections were needed in the corifollitropin alfa/GnRHant group. No patients suffered from ovarian hyperstimulation syndrome (OHSS). The other clinical outcomes including additional duration/dose of daily gonadotropin administration, number of oocytes retrieved, and fertilization rate were similar between the two groups. The implantation rate, clinical pregnancy rate, and live birth rate in the first FET cycle were also similar between the two groups. In women with PCOS undergoing IVF/ICSI treatment, corifollitropin alfa/PPOS protocol could minimize the injections burden with comparable outcomes to corifollitropin alfa/GnRHant protocol.

P–602 Pregnancy outcomes of progestin primed ovarian stimulation protocol, GnRH antagonist protocol and GnRH agonist protocol for young patients undergoing PGT-M

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Li ◽  
W Zhao ◽  
X Liang
Keyword(s):  
Genetic Testing ◽  
Gnrh Agonist ◽  
Pregnancy Outcomes ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Young Patients ◽  
Stimulation Protocol ◽  
Preimplantation Genetic Testing ◽  
Gnrh Antagonist Protocol ◽  
Antagonist Protocol

Abstract Study question To investigate the pregnancy outcomes of progestin primed ovarian stimulation protocol, GnRH antagonist protocol and GnRH agonist protocol for young patients undergoing preimplantation genetic testing for monogenic gene diseases. Summary answer PPOS protocol could reduce the normal chromosome formation and further development potential of embryos, suggesting that the PPOS protocol should be used cautiously. What is known already GnRH antagonist protocol (GnRHant) and GnRH agonist protocol (GnRHa) have been used in clinic for many years as routine regimens, and their ovarian stimulation effects and pregnancy outcomes have been confirmed by a large number of literatures. As a new protocol in recent years, the reports of pregnancy outcomes of progestin primed ovarian stimulation protocol (PPOS) are inconsistent. Study design, size, duration This retrospective cohort study was performed in a reproduction center from a tertiary hospital between September 2018 and November 2020 which included 147 young patients (<35 year old) undergoing preimplantation genetic testing for monogenic gene diseases (PGT-M) after stimulated by progestin primed ovarian stimulation protocol (n = 44), GnRH antagonist protocol (n = 60) or GnRH agonist protocol (n = 43). Participants/materials, setting, methods This study included 147 young patients (<35 year old) undergoing preimplantation genetic testing for monogenic gene diseases (PGT-M) after stimulated by progestin primed ovarian stimulation protocol (PPOS, n = 44), GnRH antagonist protocol (GnRHant, n = 60) or GnRH agonist protocol (GnRHa, n = 43). The primary outcomes were normal karyotype embryo rate and live birth rate. The embryological and clinical outcomes were measured. Main results and the role of chance Basic characteristics such as infertility duration, age, and body mass index (BMI) were comparable in study groups. No significant difference was found in the number oocytes retrieved or viable embryos between the groups. Normal karyotype embryo rate of PPOS protocol was significantly lower than GnRHant and GnRHa protocol (57.6% for PPOS vs 76.0% for GnRHant vs 67.3% for GnRHa). No significant difference were found in chemical pregnancy rate (77.3% for PPOS vs 73.3% for GnRHant vs 74.4% for GnRHa) or clinical pregnancy rate (69.8% for PPOS vs 71.7% for GnRHant vs 72.5% for GnRHa). While live birth rate of PPOS protocol was significantly lower than GnRHant and GnRHa protocol ( 45.5% for PPOS vs 58.3% for GnRHant vs 72.2% for GnRHa). Limitations, reasons for caution This is a preliminary study which needs to be further confirmed by large-scale clinical studies. Wider implications of the findings: Although this is a preliminary study which needs to be further confirmed by large-scale clinical studies, the current results suggest that the application of PPOS should be cautious. Trial registration number -

scholarly journals Ovarian stimulation in women with high and low body mass index: GnRH agonist versus GnRH antagonist

2010 ◽  
Vol 20 (3) ◽  
pp. 314-319 ◽  
Author(s):  
Banu Kumbak ◽  
Hande Akbas ◽  
Levent Sahin ◽  
Guvenc Karlikaya ◽  
Hale Karagozoglu ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Low Body Mass Index
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