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BMC Pregnancy and Childbirth

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Open Access 01-12-2021 | ICSI | Research article

Fixed versus flexible antagonist protocol in women with predicted high ovarian response except PCOS: a randomized controlled trial

Authors: Xiu Luo, Li Pei, Fujie Li, Chunli Li, Guoning Huang, Hong Ye

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

Abstract

Background

No previous study directly compares the fixed day-5 initiation versus the flexible initiation of GnRH antagonist administration in IVF/ICSI for those patients who are predicted as high ovarian responders without PCOS. To evaluate whether the number of oocytes retrieved is different by using the two GnRH antagonist protocols in Chinese women with predicted high ovarian response except PCOS.

Methods

A randomized controlled trial of 201 infertile women with predicted high ovarian response except PCOS undergoing in vitro fertilization. Ovary stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist ganirelix (0.25 mg/d) was started either on day 5 of stimulation (fixed group) or when LH was > 10 IU/L, and/or a follicle with mean diameter > 12 mm was present, and/or serum E₂ was > 600 pg/ml. Patient monitoring was initiated on day 3 of stimulation in flexible group.

Result(s)

No significant difference was observed between the fixed and flexible groups regarding the number of oocytes retrieved (16.72 ± 7.25 vs. 17.47 ± 5.88, P = 0.421), the Gonadotropin treatment duration (9.53 ± 1.07 vs. 9.67 ± 1.03, P = 0.346) and total Gonadotropin dose (1427.75 ± 210.6 vs. 1455.94 ± 243.44, P = 0.381). GnRH antagonist treatment duration in fixed protocol was statistically longer than the flexible protocol (6.57 ± 1.17 vs 6.04 ± 1.03, P = 0.001). There was no premature LH surge in either protocol.

Conclusion(s)

Fixed GnRH antagonist administration on day 5 of stimulation appear to achieve a comparable oocyte retrieved compared with flexible antagonist administration.

Trial registration

NCT02635607 posted on December 16, 2015 in clinicaltrials.gov.

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Title: Fixed versus flexible antagonist protocol in women with predicted high ovarian response except PCOS: a randomized controlled trial
Authors: Xiu Luo
Li Pei
Fujie Li
Chunli Li
Guoning Huang
Hong Ye
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: ICSI
Published in: BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-021-03833-2

2024 ASCO Annual Meeting

Springer Medicine

Fixed versus flexible antagonist protocol in women with predicted high ovarian response except PCOS: a randomized controlled trial

Abstract

Background

Methods

Result(s)

Conclusion(s)

Trial registration

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Result(s)

Conclusion(s)

Trial registration

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