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08:46
Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
Published on: September 16, 2021
GnRH antagonists in ovarian stimulation for IVF
B C Tarlatzis1, B C Fauser, E M Kolibianakis
1Unit for Human Reproduction, 1st Department of Obstetrics and Gynaecology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Nea Efkarpia Peripheral Road, Thessaloniki 54603, Greece. tarlatzis@hol.gr
Human Reproduction Update
|March 29, 2006
Summary
Gonadotropin-releasing hormone (GnRH) antagonists effectively prevent premature LH surges in IVF ovarian stimulation. While pregnancy rates may be slightly lower compared to GnRH agonists, further research is needed on optimal regimens.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization (IVF)
Background:
- Ovarian stimulation protocols are crucial for IVF success.
- Gonadotropin-releasing hormone (GnRH) antagonists offer an alternative to GnRH agonists for preventing premature luteinizing hormone (LH) surges.
Purpose of the Study:
- To review expert consensus on GnRH antagonist use in IVF ovarian stimulation.
- To evaluate current evidence on GnRH antagonist efficacy, safety, and optimal protocols.
Main Methods:
- Review of available evidence and expert consensus.
- Analysis of comparative studies and meta-analyses on GnRH antagonist versus GnRH agonist protocols.
Main Results:
- GnRH antagonists effectively suppress premature LH rise.
- Slight, non-significant reduction in pregnancy rates observed with GnRH antagonists compared to agonists.
- No evidence supports modifying starting gonadotropin doses or increasing doses upon GnRH antagonist initiation.
- GnRH agonist trigger for oocyte maturation is associated with lower pregnancy rates.
- Day 6 GnRH antagonist initiation appears superior to flexible follicle-based initiation.
- Luteal phase support is mandatory; effects on OHSS are uncertain but potentially favorable for antagonists.
Conclusions:
- GnRH antagonists are a promising option for IVF ovarian stimulation.
- Further research is required to determine optimal dosing regimens and clinical outcomes.
- Current data do not support routine LH addition or GnRH agonist trigger for oocyte maturation.
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