GnRH antagonist protocol versus long-acting GnRH agonist protocol on pregnancy outcomes in IVF/ICSI: a retrospective...

Gonadotropin-releasing hormone (GnRH) antagonist and long-acting GnRH agonist regimens are commonly employed for ovarian stimulation in women undergoing in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), but their relative efficacy in improving pregnancy outcomes remains controversial. Previous studies has yielded conflicting results, leaving clinicians and researchers uncertain about which protocol is more favorable. Given the high prevalence of infertility and the importance of improving pregnancy outcomes for these patients, understanding the differences in the efficacy of these two protocols is crucial. Therefore, our study aims to conduct a direct comparison of pregnancy outcomes between patients using GnRH antagonist protocol or long-acting GnRH agonist protocol.

This retrospective study included 575 women with primary infertility who underwent IVF/ICSI at our hospital between January 2021 and December 2022. The study included 501 women who underwent the GnRH antagonist protocol and 74 who underwent the long-acting GnRH agonist protocol. The investigated outcomes included biochemical pregnancy, clinical pregnancy, abnormal pregnancy, miscarriage, and live birth rates.

Univariate analysis found no significant differences between the GnRH antagonist and long-acting GnRH agonist protocols for biochemical pregnancy rate, clinical pregnancy rate, abnormal pregnancy rate, and miscarriage rate, whereas the GnRH antagonist protocol was associated with a lower live birth rate than the long-acting GnRH agonist protocol. After adjusting for potential confounding factors, no significant differences were found between the two protocols for biochemical pregnancy, clinical pregnancy, abnormal pregnancy, miscarriage, and live birth rates.

Our study results show that the GnRH antagonist and long-acting GnRH agonist protocols yielded comparable outcomes in terms of pregnancy outcomes. Further large-scale prospective studies are required to confirm these findings.