Volume 71, Issue 8 (November 2013)
Tehran Univ Med J 2013, 71(8): 518-523 |
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Mehrafza M, Raoufi A, Abdollahian P, Nikpouri Z, Nasiri M, Hosseini A. In vitro fertilization outcome in patients with polycystic ovary syndrome treated with GnRH analogue. Tehran Univ Med J 2013; 71 (8) :518-523
URL: http://tumj.tums.ac.ir/article-1-5608-en.html
URL: http://tumj.tums.ac.ir/article-1-5608-en.html
In vitro fertilization outcome in patients with polycystic ovary syndrome treated with GnRH analogue
Marzieh Mehrafza * 
1, Azadeh Raoufi2 , Parvaneh Abdollahian2 , Zahra Nikpouri2 , Mehri Nasiri2 , Ahmad Hosseini3
1, Azadeh Raoufi2 , Parvaneh Abdollahian2 , Zahra Nikpouri2 , Mehri Nasiri2 , Ahmad Hosseini3
1- Infertility Research Center, Mehr Medical Institute, Rasht, Iran Developmental Biologist, Rasht, Iran. , dr.mehrafza@yahoo.com
2- Infertility Research Center, Mehr Medical Institute, Rasht, Iran Developmental Biologist, Rasht, Iran.
3- Infertility Research Center, Mehr Medical Institute, Rasht, Iran Developmental Biologist, Rasht, Iran. Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
2- Infertility Research Center, Mehr Medical Institute, Rasht, Iran Developmental Biologist, Rasht, Iran.
3- Infertility Research Center, Mehr Medical Institute, Rasht, Iran Developmental Biologist, Rasht, Iran. Cellular and Molecular Biology Research Center, Shahid Beheshti University of Medical Sciences,Tehran, Iran.
Abstract: (7524 Views)
Background: 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.
Methods: 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 21st 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.
Results: 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 II (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).
Conclusion: 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.
Methods: 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 21st 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.
Results: 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 II (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).
Conclusion: 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.
Type of Study: Original Article |
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