A Comparative Study between GnRH Antagonist and Long Agonist Protocols in Patients with Polycystic Ovarian Syndrome (PCOS) Undergoing in vitro Fertilization

We compared the efficacy and safety of GnRH antagonist protocol and GnRH long agonist protocol in patients with PCOS undergoing IVF/ICSI. A total of 100 patients with PCOS candidate for IVF/ICSI were prospectively studied. Patients were randomly allocated to either antagonist or agonist groups. There was no significant difference between the two groups as regards the clinical pregnancy rate, ongoing pregnancy rate, miscarriage rate per clinical pregnancy and multiple pregnancy rates. However, there was a significantly lower dose and shorter duration of gonadotropin stimulation and lower incidence of severe ovarian hyperstimulation syndrome (OHSS) in the antagonist group (P = 0.001, 0.001 and 0.01 respectively). GnRH antagonist protocol may be the protocol of choice in PCOS patients undergoing IVF / ICSI.