Cetrorelix protocol versus gonadotropin-releasing hormone analog suppression long protocol for superovulation in intracytoplasmic sperm injection patients older than 40
Received 12 December 2007; received in revised form 26 February 2008; accepted 26 February 2008. published online 23 May 2008.
Objective
To determine which protocols work better between cetrorelix and long protocols in older patients in a randomized controlled study.
Design
A controlled randomized study in a single private IVF center.
Setting
Infertile women referred to a private IVF center.
Patient(s)
Five hundred sixty-four women 40 years or older undergoing IVF.
Intervention(s)
At their first IVF cycle, the women were randomized into two study groups using a computer-generated number sequence: 281 cases were treated with the cetrorelix protocol, and 283 patients were treated with a long protocol for controlled ovarian hyperstimulation.
Main Outcome Measure(s)
Days of stimulation, E2 on the day of hCG administration, amount of FSH administered, number of oocytes yielded, number of embryos obtained, pregnancy rate, and implantation rate.
Result(s)
Patients treated with the long protocol showed a significantly higher number of oocytes retrieved and a higher pregnancy rate for both the cycle and transfer with respect to the cetrorelix protocol patients. The other parameter evaluated did not show any statistically significant differences.
Conclusion(s)
Our study showed that the long protocol performed better in older women than the cetrorelix protocol and that the GnRH antagonist may be detrimental in older women.
Reprint requests: Marco Sbracia, M.D., Center for Endocrinology and Reproductive Medicine, Via Carlo Porta 10, 00153, Rome, Italy (FAX: 39-06-5880096).
M.S. has nothing to disclose. J.C. has nothing to disclose. A.G. has nothing to disclose. P.G. has nothing to disclose. C.P. has nothing to disclose. F.M. has nothing to disclose. M.M. has nothing to disclose. M.S. has nothing to disclose.
ABSTRACT