Efficacy of Stop GnRH-Agonist/Antagonist versus GnRH-Antagonist Protocols in In Vitro Fertilization Cycles of Patients with Polycystic Ovary Syndrome: A Pilot Randomized Controlled Trial
نویسندگان
1 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
2 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
3 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
4 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
5 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
6 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
7 Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
8 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
doi
10.22074/ijfs.2025.2041275.1762چکیده
Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder impacting fertility. Controlledovarian stimulation (COS) is a crucial step during in vitro fertilization (IVF) procedure to enhance oocyte retrievaland embryo generation. This study aims to compare the efficacy of the stop gonadotropin hormone-releasing hormoneagonist (GnRH-agonist)/GnRH-antagonist protocol versus the conventional GnRH antagonist protocol in PCOS patientsundergoing IVF.Materials and Methods: A pilot randomized controlled trial was conducted from March to December 2023 at Vali-E-Asr Hospital, Tehran. Forty PCOS patients were randomized into two groups: stop GnRH-agonist/GnRH-antagonist(n=20) and conventional GnRH antagonist (n=20). Participants’ demographics, hormonal profiles, and treatmentoutcomes were recorded. The primary outcome was the number of mature oocytes retrieved; secondary outcomesincluded the number of follicles >12 mm on human chorionic gonadotropin (hCG) administration day and ovarianhyperstimulation syndrome (OHSS) incidence. Data was analyzed using SPSS 21.0, employing t tests, Mann-Whitneytests, and Chi-square tests as appropriate.Results: Baseline characteristics were similar between groups. The conventional protocol group had significantlymore 16-18 mm follicles but no differences in total oocytes retrieved, metaphase 1 and 2 oocytes, or degenerated oocytes.Stimulation duration was shorter in the conventional group. No significant differences were observed in OHSSincidence or total gonadotropin dose.Conclusion: The Stop GnRH-agonist/GnRH-antagonist protocol is a viable alternative for PCOS patients, offeringcomparable oocyte yields and safety profiles to the conventional GnRH antagonist protocol. Larger studies are neededto confirm these findings and evaluate long-term outcomes such as pregnancy and live birth rates (registration number:IRCT20180409039247N10).
