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Optimizing Ovarian Stimulation for IVF in PCOS Patients: A Novel Day 1 GnRH Antagonist Protocol
Sudarsan Ghosh Dastidar1, Biswanath Ghosh Dastidar1,2, Ratna Chattopadhyay3
1GD Institute for Fertility Research, 36 A/1 S.P. Mukherjee Road, Kolkata 700025, West Bengal, India.
Journal of Clinical Medicine
|August 28, 2025
Summary
Starting gonadotropin-releasing hormone (GnRH) antagonist administration on day 1 of ovarian stimulation in women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) significantly improved oocyte yield and embryo quality, suggesting better outcomes.
Area of Science:
- Reproductive Endocrinology
- In Vitro Fertilization
- Ovarian Stimulation Protocols
Background:
- Gonadotropin-releasing hormone (GnRH) antagonist protocols are favored for women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF) due to their flexibility, safety, and efficacy.
- While comparisons exist between GnRH agonist and antagonist protocols, limited research addresses the optimal timing of GnRH antagonist administration in PCOS patients.
Purpose of the Study:
- To compare laboratory and clinical outcomes of in vitro fertilization (IVF) between standard flexible day 5/6 and early day 1 GnRH antagonist administration protocols in patients with polycystic ovary syndrome (PCOS).
Main Methods:
- Retrospective cohort study design.
- Comparison of IVF outcomes between two GnRH antagonist administration protocols: standard flexible (day 5/6) versus early (day 1).
- Analysis focused on laboratory parameters and clinical pregnancy rates in PCOS patients.
Main Results:
- Patients receiving GnRH antagonists from day 1 demonstrated significantly higher oocyte yield.
- A superior proportion of top-quality embryos was observed in the day 1 antagonist group.
- Cumulative clinical pregnancy rates showed a trend towards improvement in the day 1 antagonist group.
Conclusions:
- Initiating GnRH antagonist administration on day 1 of ovarian stimulation in PCOS patients undergoing IVF may enhance reproductive outcomes.
- Early GnRH antagonist administration appears to be a promising strategy for improving IVF success rates in this patient population.
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