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What are the best predictors for successful GnRH antagonist protocol in in vitro fertilization (IVF) treatment?
Nivin Samara1, Daniel Reis1, Netanella Danielli Miller1
1a IVF Unit, Department of Obstetrics and Gynecology , Meir Medical Center , Kfar Saba , Israel , affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv , Israel.
Objective:
To determine factors that affect the success rate of GnRH antagonist protocol in in vitro fertilization (IVF) treatment.
Design:
Retrospective cohort study.
Patients:
Patients who underwent IVF cycle with their first GnRH antagonist protocol.
Intervention:
Antagonist protocol during IVF treatment. The main outcome measurements were; Number of retrieved oocytes, embryo quality and pregnancy rate.
Results:
Gravidity was negatively correlated with number of eggs (p = 0.017), while total follicle number ≥15 (p = 0.044) and E(2) on day of human chorionic gonadotropin (HCG) (p = 0.000) had a positive correlation with number of eggs. Maximum follicle size at HCG administration showed a trend toward an inverse correlation (p = 0.053). Addition of LH to drug stimulation was negatively correlated with number of eggs in comparison to rFSH only (p = 0.013 and 0.0000, respectively). Age and number of frozen eggs were negatively correlated with successful pregnancy (p = 0.025 and 0.004, respectively), while embryo quality, gravidity and number of embryos were positive (p = 0.011 and 0.014, respectively).
Conclusion:
Controlled parameters like timing of antagonist start, duration of antagonist and the optimal leading follicle diameter for HCG triggering had no effect on treatment outcomes.
