ABSTRACT
Polycystic ovarian syndrome [PCOS] is the most common endocrinological disorders that affect approximately 5-7% of women in reproductive age. There is not any consensus about the efficient in vitro fertilization [IVF] protocol for patients with PCOS. The aim of the present study was to compare the half and one-third dose depot gonadotropin-releasing hormone [GnRH] agonist protocols versus the GnRH antagonist protocol in PCOS patients. In the present study, we retrospectively evaluated 119 infertile women with PCOS. The patients entered in the study in accordance with Rotterdam criteria. According to GnRH analogue used for pituitary suppression, patients were divided into three groups: half and one-third dose depot GnRH agonist protocols and GnRH antagonist protocol. In GnRH agonist protocol, half or one-third dose depot Decapeptyl [1.875 mg, 1.25 mg] was injected on 21[st] day of previous cycle. In GnRH antagonist cycles, cetrotide 0.25 mg were administered daily when the leading follicles reached 14 mm. All basal and controlled ovarian hyperstimulation [COH] characteristics were analyzed. Basal characteristics including: age, FBS, prolactin, hirsutism, length of menstrual cycle were similar between 3 groups. Statically significant decreases in days of stimulation, number of gonadotrophin ampoules and metaphase two [MII] oocytes were found in GnRH antagonist protocol [P<0.001, P<0.001 and P=0.045], while the decrease in biochemical pregnancy [P=0.083] and live birth rate [P=0.169] wasn't significant. Number of embryos transferred were similar in the half and one-third dose depot GnRH agonist and GnRH antagonist cycles [P=0.881]. The incidence of OHSS weren't significantly different between 3 groups [5%, 4.9% and 12.8%, P=0.308]. Our study suggest that one-third dose depot GnRH agonist protocol could be a suitable choice for treatment of PCOS because of lower incidence of ovarian hyperstimulation syndrome [OHSS] as compared with half dose depot GnRH agonist and higher pregnancy rate as compared with GnRH antagonist.
Subject(s)
Humans , Female , Gonadotropin-Releasing Hormone/analogs & derivatives , Gonadotropin-Releasing Hormone/administration & dosage , Hormone Antagonists/administration & dosage , Hormone Antagonists/adverse effects , Ovulation Induction/methods , Ovarian Hyperstimulation Syndrome/chemically induced , Fertilization in Vitro , Retrospective StudiesABSTRACT
Os autores relatam um caso de gestaçäo gemelar obtida após um ciclo de fertilizaçäo in vitro com injeçäo intracitoplasmática de espermatozóide (FIV-ICSI), em cujo protocolo de estimulaçäo ovariana foi utilizado o FSH recombinante em associaçäo com o antagonista do GnRH (Cetrorelix), segundo o protocolo de múltiplas doses (0,25 mg/dia a partir do 7§ dia de estímulo). Os resultados obtidos nos recentes estudos de ensaio clínico que analisaram a utilizaçäo do Cetrorelix em ciclos de FIV foram amplamente revisados e comparados aos resultados obtidos com o emprego dos análogos do GnRH