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Int J Clin Exp Pathol 2013;6(9):1903-1910

Original Article
Comparison of the GnRH agonist and antagonist protocol on the same patients in
assisted reproduction during controlled ovarian stimulation cycles

Qiaohong Lai, Hanwang Zhang, Guijing Zhu, Yufeng Li, Lei Jin, Long He, Zhijun Zhang, Ping Yang, Qilin Yu, Shu Zhang, Jun-Fa Xu, Cong-Yi
Wang

The Center for Biomedical Research, Department of Obstetric and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of
Science and Technology, Wuhan 430030, China; Department of Clinical Immunology, Institute of Laboratory Medicine, Guangdong Medical
College, Dongguan 523808, China

Received May 29, 2013; Accepted August 15, 2013; Epub August 15, 2013; Published September 1, 2013

Abstract: Despite the fact that both gonadotropin-releasing hormone (GnRH) agonist and antagonist protocol are effective in suppressing the
incidence of premature luteinizing hormone (LH) surges through reversibly blocking the secretion of pituitary gonadotropins, the exact impact of
these two distinctive protocols on the clinical setting of patients for in vitro fertilization and embryo transfer (IVF-ET) treatment, however,
remained controversial. We thus in the present report conducted a retrospective study to compare the impact of GnRH agonist and antagonist
protocol on the same patients during controlled ovarian stimulation cycles. A total of 81 patients undergoing 105 agonist and 88 antagonist
protocol were analyzed. We failed to detect a significant difference between two protocols for the difference in duration of ovarian stimulation,
number of recombinant FSH (Gonal-F) ampoules used, number of oocytes retrieved, serum levels for estradiol (E2) and progestone (P),
thickness of endometrium, and the zygote- and blastocyst-development rate. It is seemly that high quality embryo rate was higher in the
antagonist protocol, but the data did not reach a statistical significance. Nevertheless, Implantation rate and clinical pregnancy rate were
significantly higher in the antagonist protocol (10.64% and 30.26%, respectively) than that of the agonist protocol (5.26% and 15.82%,
respectively). Our data also suggest that the GnRH antagonist protocol is likely to have the advantage for improving the outcome of pregnancy
in those patients with a history of multiple failures for the IVF-ET treatment. (IJCEP1305036).

Keywords: Gonadotropin-releasing hormone (GnRH), agonist, antagonist, in vitro fertilization, embryo transfer, assisted reproduction,
controlled ovarian stimulation cycles

Address correspondence to: Dr. Cong-Yi Wang, The Center for Biomedical Research, Tongji Hospital, Tongji Medical College, Huazhong
University of Science and Technology, 1095 Jiefng Ave., Wuhan 430030, China. Tel: 86-27-8366-3485; E-mail: wangcy@tjh.tjmu.edu.cn