Biomedical Letters

A Comparison between GnRH Agonist Long and GnRH Antagonist Protocol for In vitro Fertilization: A Review

Ranjana Giri, Yazhong Ji, Feng Yang, Xiaowen Tong*

Department of Gynecology and Obstetrics, Shanghai Tongji Hospital, Tongji University School of Medicine, No. 389 Xincun Road, Putuo District, Shanghai, 200065, China

Abstract

In early years, for the in vitro fertilization (IVF), gonadotropin-releasing hormone (GnRH) agonist long protocol play a key role for poor ovarian responders and was used for ovarian stimulation to inhibit the premature surge of luteinizing hormone. Although it had a number of side effects, this method was widely accepted and used as a long duration protocol treatment, which also increased the pregnancy rate and a number of oocytes retrieved. With the administration of the agonist, follicular stimulating hormone (FSH) and LH increases. Different studies and meta-analysis have shown major complication leading to higher incidence of hospital admission associated with the ovarian hyperstimulation syndrome (OHSS). Thus, to overcome these complications, various studies were conducted using GnRH antagonist which had an immediate mode of action, shorter duration, decrease hospital stay and beneficial to patients undergoing ovarian stimulations. Comparative studies between these two analogues have shown antagonist being the “drug of choice” even though the probability of live births does not rely on the type analogue used. In recent years, it is anticipated that the protocol of GnRH antagonist could improve the achievement of pregnancy outcomes compared to GnRH agonist, however, after the introduction of GnRH antagonist it has proved and appreciated as an additional support to ovarian stimulation in IVF cycles on the basis of patient’s benefits and the clinicians are taking advantage of these benefits.

Keywords: GnRH agonist, GnRH antagonist, IVF, follicular stimulating hormone, OHSS.

Received January 4, 2017 Revised February 26, 2017 Accepted March 12, 2017

*Correspondence: Xiaowen Tong Email xiaowen_tong@hotmail.com Contact: +8613601626510