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Related Experiment Videos

Comparison between "short" and "long" protocols in an ICSI programme.

D Loutradis1, K Stefanidis, P Drakakis

  • 11(st) Department of Obstetrics and Gynecology, IVF Unit, "Alexandra" Maternity Hospital, Athens University, Medical School, Athens, Greece.

European Journal of Obstetrics, Gynecology, and Reproductive Biology
|May 4, 2005
PubMed
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The long protocol for controlled ovarian hyperstimulation (COH) using gonadotropin-releasing hormone (GnRH) agonist resulted in significantly higher clinical pregnancy rates per embryo transfer compared to the short protocol in ICSI programs. This suggests the long protocol may be more effective for patients with male factor infertility.

Area of Science:

  • Reproductive Endocrinology
  • In Vitro Fertilization
  • Medical Research

Background:

  • Controlled ovarian hyperstimulation (COH) is a key component of assisted reproductive technologies.
  • Gonadotropin-releasing hormone (GnRH) agonists are widely used to prevent premature luteinizing hormone surges during COH.
  • Different administration protocols for GnRH agonists, such as long and short protocols, exist with varying clinical outcomes.

Purpose of the Study:

  • To compare the efficacy of GnRH agonist in a long protocol versus a short protocol for COH.
  • To evaluate outcomes in patients undergoing intracytoplasmic sperm injection (ICSI) with a history of male factor infertility.
  • To determine which GnRH agonist protocol yields better pregnancy rates in this specific patient population.

Main Methods:

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  • Retrospective study design.
  • Inclusion of 424 consecutive patients with male factor infertility undergoing ICSI.
  • Categorization of patients into two groups: GnRH agonist long protocol (n=303) and GnRH agonist short protocol (n=121).

Main Results:

  • Patients in the short protocol group experienced shorter stimulation times and lower estradiol levels.
  • A significantly higher percentage of oocytes were transferred in the long protocol group.
  • The clinical pregnancy rate per embryo transfer was significantly higher in the long protocol group (39.3%) compared to the short protocol group (19.2%) (p=0.001).

Conclusions:

  • The GnRH agonist long protocol demonstrates superior efficacy in achieving clinical pregnancies per embryo transfer in ICSI programs for patients with male factor infertility.
  • The short protocol, while associated with shorter stimulation and lower estradiol levels, resulted in lower pregnancy rates.
  • These findings suggest that the long protocol may be a more effective strategy for this patient cohort.