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GnRH Antagonists Effective Option in IVF

Protocol safer and more effective than GnRH agonists protocol; has similar live-birth rate

FRIDAY, May 13 (HealthDay News) -- The treatment of women with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) with gonadotrophin-releasing hormone (GnRH) antagonists results in a similar live-birth rate, and is associated with a lower incidence of ovarian hyperstimulation syndrome (OHSS) compared to standard treatment with GnRH agonists, according to a meta-analysis published online May 11 in the Cochrane Database of Systematic Reviews.

Hesham G. Al-Inany, M.D., from Cairo University in Egypt, and colleagues compared the efficacy and safety of GnRH antagonists with the more widely used protocol of GnRH agonists (long protocol) for controlled ovarian hyperstimulation in assisted conception cycle. Data were collected from major databases, bibliographies of applicable publications and reviews, and abstracts of major scientific meetings. Forty-five randomized controlled trials (RCTs) were identified, including 7,511 women, comparing the two protocols for women undergoing IVF or ICSI.

The investigators found that there was no statistically significant difference in live-birth rates based on nine RCTs or ongoing pregnancy based on data from 28 RCTs. The GnRH antagonist group had a statistically significant lower incidence of OHSS (29 RCTs; odds ratio, 0.43).

"The use of antagonist compared with long GnRH agonist protocols was associated with a large reduction in OHSS and there was no evidence of a difference in live-birth rates," the authors write.

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