Fixed versus flexible antagonist protocol in women with predicted high ovarian response except PCOS: a randomized controlled trial

BMC Pregnancy and Childbirth

Li Pei¹  Fujie Li²  Xiu Luo³  Hong Ye³  Guoning Huang³  Chunli Li⁴ 

[1] Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China;Reproductive and Genetic Institute, Chongqing Health Center for Women and Children, Chongqing, China;Chongqing Key Laboratory of Human embryo Engineering, Chongqing, China;Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China;Chongqing Key Laboratory of Human embryo Engineering, Chongqing, China;Chongqing Clinical Research Center for Reproductive Medicine, Chongqing, China;Reproductive and Genetic Institute, Chongqing Health Center for Women and Children, Chongqing, China;Reproductive and Genetic Institute, Chongqing Health Center for Women and Children, Chongqing, China;

关键词: Gonadotropin-releasing hormone antagonists;    In vitro fertilization;    Fixed protocol;    Flexible protocol;    Number of oocytes retrieved;   

DOI  :  10.1186/s12884-021-03833-2

来源: Springer

【 摘 要 】

BackgroundNo previous study directly compares the fixed day-5 initiation versus the flexible initiation of GnRH antagonist administration in IVF/ICSI for those patients who are predicted as high ovarian responders without PCOS. To evaluate whether the number of oocytes retrieved is different by using the two GnRH antagonist protocols in Chinese women with predicted high ovarian response except PCOS.MethodsA randomized controlled trial of 201 infertile women with predicted high ovarian response except PCOS undergoing in vitro fertilization. Ovary stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist ganirelix (0.25 mg/d) was started either on day 5 of stimulation (fixed group) or when LH was > 10 IU/L, and/or a follicle with mean diameter > 12 mm was present, and/or serum E2 was > 600 pg/ml. Patient monitoring was initiated on day 3 of stimulation in flexible group.Result(s)No significant difference was observed between the fixed and flexible groups regarding the number of oocytes retrieved (16.72 ± 7.25 vs. 17.47 ± 5.88, P = 0.421), the Gonadotropin treatment duration (9.53 ± 1.07 vs. 9.67 ± 1.03, P = 0.346) and total Gonadotropin dose (1427.75 ± 210.6 vs. 1455.94 ± 243.44, P = 0.381). GnRH antagonist treatment duration in fixed protocol was statistically longer than the flexible protocol (6.57 ± 1.17 vs 6.04 ± 1.03, P = 0.001). There was no premature LH surge in either protocol.Conclusion(s)Fixed GnRH antagonist administration on day 5 of stimulation appear to achieve a comparable oocyte retrieved compared with flexible antagonist administration.Trial registrationNCT02635607 posted on December 16, 2015 in clinicaltrials.gov.

【 授权许可】

CC BY