Why antagonist protocol

In some cases, you will start a birth control pill first. Birth control pills can be given for days to prepare your body for IVF by regulating your ovarian hormones, and by preventing ovarian cysts. They are also beneficial in timing the start of your IVF cycle.

After completing birth control, or following your baseline visit, you will begin the IVF antagonist protocol. This medication is started when your estrogen level rises above a certain threshold, or based on the size of your largest follicle on ultrasound, and is continued until the time of your hCG trigger shot.

He has been recognized by his peers and patient advocacy organizations for his commitment to patient-focused and data-driven care. He has published more than original manuscripts and book chapters on reproductive medicine and has co-authored over scientific abstracts on infertility, in vitro fertilization, egg freezing, ovum donation, and reproductive genetics. You may be instructed to use birth control pills prior to starting an IVF cycle. Starting around the fifth day, the Gonadotropin-Releasing Hormone GnRH antagonist is added to prevent premature ovulation.

Lupron Down Regulation, or Long Lupron Protocol : This protocol may be used in younger patients or in patients who have poor embryo quality from other protocols. You may be instructed to use birth control pills before you start an IVF cycle. By week three, your doctor will administer an injectable medication called Lupron. The SPSS statistical software package version The unpaired Student t-test was used to compare means from two groups.

The patient demographic variables are compared in Table 1. The two groups were similar in terms of body mass index, basal FSH level, proportion of primary infertility and IVF cycles. The duration of stimulation in the GnRHa group was There was a significant difference in E 2 levels on the hCG day between the two groups However, the total dose of Gn was similar between the two groups In the GnRHa group, the number of cancelled freshly transferred cycles was 85 cycles, and Young patients with good ovarian reserves are at high risk of OHSS.

The most optimal protocol for high responders should have an acceptable rate of cancellation, obtain moderate healthy mature oocytes and high quality embryos at a reasonable cost and duration of therapy, provide a suitable endometrium for implantation, and have maximal pregnancy and live birth rates [ 15 ].

For over 20 years, GnRH agonists have been used to prevent the luteinizing hormone LH surge that results from multiple follicular development [ 1 ]. However, more and more studies are demonstrating that the GnRH agonist protocol can induce severe OHSS, especially for potentially high responders. Many researchers have demonstrated that there are several advantages in antagonist methods, including a shorter duration of Gn and a smaller dose of Gn per cycle [ 16 ].

Conflicting evidence still exists regarding the superiority of one protocol over the other [ 17 ]. Our results showed that the duration of stimulation in the GnRHa group was These findings were in agreement with previous studies. However, one meta-analysis including five randomized controlled studies suggested that the incidence of severe OHSS was not associated with the type of analogue [ 19 ]. In the present study, we found that in the GnRHa group, However, many studies have also demonstrated that pregnancy rates are decreased in the GnRH antagonist protocol compared with the GnRH agonist protocol [ 11 ].

The long GnRH agonist protocol is still considered a classical, gold standard protocol for young patients, even though there is a high risk of OHSS [ 20 ]. Several reasons can explain why the long protocol was better than GnRH antagonist protocol: 1 The long protocol can lead to complete suppression and lower serum LH level.

Under these conditions, the endometrium may be more suitable for embryo implantation. Previous studies have showed that LH may exert direct effects on the endometrium [ 21 ]. Some recent studies suggested that lower serum LH levels in the long-acting GnRHa protocol might play a beneficial role for endometrial receptivity. So, it can promote better follicle recruitment and more oocytes harvested. Long GnRH-a protocol is a classical protocol for the patients and has gained widespread popularity.

In conclusion, our study demonstrated that for potentially high responders, the GnRHant protocol can, to some extent, lower the cancellation rate and the incidence of OHSS. However, the GnRHa protocol was superior to the GnRHant protocol in terms of normal fertilization rate, implantation rates and clinical pregnancy rates. Analyzed the data: WJX.

Wrote the paper: WJX. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Conclusions Our study demonstrated that for potentially high responders, the GnRHant protocol can, to some extent, lower the cancellation and incidence rates of OHSS. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Data Availability: All relevant data are within the paper.

Funding: The authors have no support or funding to report. Download: PPT. Conclusions In conclusion, our study demonstrated that for potentially high responders, the GnRHant protocol can, to some extent, lower the cancellation rate and the incidence of OHSS.