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Related Concept Videos

In Vitro Fertilization01:24

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Updated: Apr 30, 2026

Fertility Preservation in Patients with Severe Ovarian Dysfunction
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GnRH Antagonist IVF Protocol in PCOS.

Alina Onofriescu1, A Bors2, A Luca3

  • 1Department of Diabetology, University of Medicine and Pharmacy of Iaşi.

Current Health Sciences Journal
|April 30, 2014
PubMed
Summary

The flexible GnRH antagonist protocol shows similar pregnancy rates to the GnRH agonist protocol but with a significantly lower incidence of Ovarian Hyperstimulation Syndrome (OHSS) in women with PCOS undergoing controlled ovarian stimulation (COS). This protocol also requires less gonadotropin and shorter stimulation duration.

Keywords:
GnRH antagonistinfertilitypolycystic ovary syndrome

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Area of Science:

  • Reproductive Endocrinology
  • Infertility Treatment
  • Assisted Reproductive Technologies

Background:

  • Polycystic Ovary Syndrome (PCOS) is a common cause of infertility.
  • Controlled Ovarian Stimulation (COS) is a key component of In Vitro Fertilization (IVF).
  • Gonadotropin-Releasing Hormone (GnRH) analogs are used to prevent premature ovulation during COS.

Purpose of the Study:

  • To compare the GnRH agonist long protocol with the flexible GnRH antagonist protocol for infertile PCOS women undergoing COS.
  • To evaluate clinical pregnancy rates (CPR) and the incidence of Ovarian Hyperstimulation Syndrome (OHSS).

Main Methods:

  • Prospective study comparing GnRH agonist long protocol versus flexible GnRH antagonist protocol.
  • PCOS diagnosis based on Rotterdam 2003 criteria.
  • Data collected on CPR, OHSS incidence, stimulation duration, and gonadotropin dosage.

Main Results:

  • No significant difference in clinical pregnancy rates between the agonist and antagonist protocols.
  • Lower incidence of OHSS in the antagonist group (4%) compared to the agonist group (28%).
  • Shorter stimulation duration and lower total gonadotropin requirement in the antagonist protocol.

Conclusions:

  • The flexible GnRH antagonist protocol offers comparable pregnancy rates to the GnRH agonist protocol.
  • The antagonist protocol is associated with a reduced risk of OHSS, shorter stimulation, and lower gonadotropin use.
  • GnRH antagonist protocol may be a preferred treatment choice for PCOS patients undergoing IVF.