Document Detail

Early initiation of gonadotropin-releasing hormone antagonist in polycystic ovarian syndrome patients undergoing assisted reproduction: randomized controlled trial ISRCTN69937179.
MedLine Citation:
PMID:  22960769     Owner:  NLM     Status:  MEDLINE    
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.
Mostafa I Abuzeid; Mohamed Mitwally; Yasmine M Abuzeid; Hammad A Bokhari; Mohammad Ashraf; Michael P Diamond
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-09-08
Journal Detail:
Title:  Journal of assisted reproduction and genetics     Volume:  29     ISSN:  1573-7330     ISO Abbreviation:  J. Assist. Reprod. Genet.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-06-06     Revised Date:  2013-11-05    
Medline Journal Info:
Nlm Unique ID:  9206495     Medline TA:  J Assist Reprod Genet     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1193-202     Citation Subset:  IM    
Center for Reproductive Medicine, Reproductive Endocrinology and Infertility, Department of OB/GYN, Hurley Medical Center, Flint, MI 48503, USA.
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MeSH Terms
Embryo Implantation
Embryo Transfer / methods*
Gonadotropin-Releasing Hormone / antagonists & inhibitors*
Hormone Antagonists / administration & dosage*,  therapeutic use
Infertility, Female / complications,  therapy*
Ovulation Induction / methods
Polycystic Ovary Syndrome / complications*
Pregnancy Rate
Prospective Studies
Reproductive Techniques, Assisted
Sperm Injections, Intracytoplasmic / methods
Treatment Outcome
Reg. No./Substance:
0/Hormone Antagonists; 33515-09-2/Gonadotropin-Releasing Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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