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Early initiation of gonadotropin-releasing hormone antagonist in polycystic ovarian syndrome patients undergoing assisted reproduction: randomized controlled trial ISRCTN69937179

  • ASSISTED REPRODUCTION TECHNOLOGIES
  • Published:
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Abstract

Purpose

To compare the implantation rates in two groups of women with Polycystic Ovary Syndrome (PCOS) after embryo transfer based on the initiation time of GnRH antagonist. Secondary outcome measures included clinical pregnancy, delivery and miscarriage rates.

Methods

This is a prospective, randomized trial in which 140 PCOS patients underwent ICSI, with 122 having ET performed. GnRH-antagonist was started on day 1 of stimulation in 69 patients (Group 1) or day 5 in 71 patients (Group 2).

Results

The overall implantation rate in Group 1 (46.2 %) was clinically higher than Group 2 (35.5 %), although not statistically significant (p = 0.075). For blastocysts transfer, the implantation rate in Group 1 was 55.1 %, compared to 40.4 % in Group 2 (p = 0.051). There was a clinically, but not statistically, higher clinical pregnancy rate (68.3 % vs. 56.5 %) and delivery rate (60.0 % vs. 53.2 %) per transfer in Group 1 compared to Group 2, respectively. There was a statistically significant lower biochemical pregnancy rate in Group 1 (2.4 %) compared to Group 2 (18.6 %) [p = 0.015]. There was no difference in miscarriage rates between the two groups.

Conclusion

Our data suggest that early initiation of GnRH antagonist on day 1 of ovarian stimulation in PCOS patients undergoing ICSI-ET may improve implantation rates, especially after blastocyst transfer.

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Acknowledgments

The authors would like to thank Jenny LaChance, MS, Hurley Medical Center, Flint, Michigan USA, for her assistance in the statistical analyses, and Cheryl Anderson, AAS, IVF Michigan, Hurley Medical Center, Flint, Michigan, USA for her assistance in the preparation of this manuscript.

This study was supported in part by a research grant from the Investigator-Initiated Studies Program of Merck Sharp & Dohme Corp. The opinions expressed in this paper are those of the authors and do not necessarily represent those of Merck Sharp & Dohme Corp. The authors would also like to thank Merck Sharp & Dohme Corp. for their support of this research.

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Authors and Affiliations

  1. Center for Reproductive Medicine, Reproductive Endocrinology and Infertility, Department of OB/GYN, Hurley Medical Center, Flint, MI, 48503, USA

    Mostafa I. Abuzeid & Mohammad Ashraf

  2. IVF Michigan PC, 3050 S. Rochester Road, Suite 2300, Rochester Hills, MI, 48307, USA

    Mostafa I. Abuzeid, Yasmine M. Abuzeid, Hammad A. Bokhari & Mohammad Ashraf

  3. Obstetrics and Gynecology and Reproductive Biology, Michigan State University, College of Human Medicine, Flint Campus, MI, 48823, USA

    Mostafa I. Abuzeid & Mohammad Ashraf

  4. Odessa Reproductive Medicine Center, Odessa, TX, USA

    Mohamed Mitwally

  5. Kamran S. Moghissi, Obstetrics and Gynecology, Reproductive Endocrinology & Infertility, Associate Dean for Clinical and Translational Research, School of Medicine, Executive Director for Clinical and Translational Research, Wayne State University, Detroit, MI, USA

    Michael P. Diamond

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  1. Mostafa I. Abuzeid
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  2. Mohamed Mitwally
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  3. Yasmine M. Abuzeid
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  4. Hammad A. Bokhari
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  5. Mohammad Ashraf
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Correspondence to Mostafa I. Abuzeid.

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Capsule

In patients with polycystic ovary syndrome undergoing ICSI-ET, early initiation of GnRH antagonist on day 1 of ovarian stimulation may improve implantation rates, especially after blastocyst transfer.

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Abuzeid, M.I., Mitwally, M., Abuzeid, Y.M. et al. Early initiation of gonadotropin-releasing hormone antagonist in polycystic ovarian syndrome patients undergoing assisted reproduction: randomized controlled trial ISRCTN69937179. J Assist Reprod Genet 29, 1193–1202 (2012). https://doi.org/10.1007/s10815-012-9850-7

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  • DOI: https://doi.org/10.1007/s10815-012-9850-7

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