Document Type : Original Article
Authors
1
Obstetrics and Gynecology Department, Damanhour National Medical Institute, Egypt.
2
RYADA Fertility Center, Damanhour, Egypt.
3
Egyptian Foundation of Reproductive Medicine and Embryology (EFRE), Egypt.
4
Madina ICSI Fertility Center, Madina women's hospital, Alexandria, Egypt.
5
Obstetrics and Gynecology Department, Faculty of Medicine, Alexandria University, Egypt.
Abstract
Background: An essential part of ovarian stimulation in Invitro Fertilization /Intra-Cytoplasmic Sperm Injection (IVF/ICSI) involves co-medication to prevent premature luteinization. Controlled ovarian hyperstimulation (COH) is a fundamental step. Most published reviews have insufficiently accounted for various patient populations, who are likely to be of relevance since they strongly differ about ovarian responsiveness, particularly in relation to the long agonist and antagonist protocols. Both protocols are effective in blocking premature LH surges. The main two approaches for this are pituitary desensitization with prolonged daily administration of a gonadotrophin releasing hormone (GnRH) agonist or an instant blockade of the pituitary luteinizing hormone (LH) secretion with a GnRH antagonist.
Objectives: The study aimed to compare risk and outcome of agonist and antagonist stimulation protocols.
Materials and methods: This study was carried out in ART Unit of RIYADA fertility center for year 2020-2021 include 320 patients. Patients were subdivided into two groups: Long protocol group (n = 241) was stimulated by GnRH agonist long protocol, and Antagonist Group (n = 79) was stimulated by antagonist protocol.
Results: The multiple logistic regression analysis for different risk factors of pregnancy, was significant, and the significant items were protocol used (long protocol), young age, high number of oocytes, the three items gave a high pregnancy rate if combined.
Conclusion:
The study concluded that the long protocol shows a high pregnancy rate in certain patient groups who fulfill the following criteria; age less than 37 years; Number of oocytes less than 15.
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