Comparisons Of GnRH Antagonist Verse GnRH Agonist Protocol In Patients Of Diferent Age Groups

Objective:To analyze the outeomes of GnRH antagonist protocols in IVF/ ICSI-ET cycles in four age groups and to provide reference for rational selection of ovulation stimulation protocol for patients.Methods:This was a retrospective analysis performed in the Center of reproductive medicine,the Second Hospital of Hebei Medical University,from January 2015 to December 2017.The data from 6828 cycles,including GnRH antagonist(GnRH-ant)protocol(Group A,1773 cycles)and long GnRH agonisl(Gn RH-a)protocol(Group B,5055 cycles),were divided into Sub-group A1(under 30 years of age),A2(30 to 34 years of age),A3(35 to 39 years of age)and A4(40 years and older)?B1(under 30 years of age),B2(30 to34 years of age),B3(35 to 39 years of age)and B4(40 years and older).Comparison about patients basie information and treatment outcomes in four diferent age groups.Results : Days of gonadotropin injections,estradiol(E2)level and endometrial thickness on the day of human chorionic gonadotropin(hCG)administration,number of oocytes retrieved were significantly higher in the agonists group.The incidence of severe OHSS marked decreased in antagonist group.High qualified embryo rate,pregnancy rate(PR)and live birth rate(LBR)were higher in the group agonist compared to the antagonist group.Abortion was similar between the two groups.Conclusions:1.Ovarian stimulation utilizing the long GnRH-agonist protocol is associated with a significantly better pregnancy outcome than the GnRH-antagonist protocol.2.We therefore recommend that the long GnRH-agonist protocol be offered as the primary protocol,but this should be weighed against themoderately higher chance of developing OHSS.3.The GnRH antagonist has no adverse effects on assisted reproductive technology outcome,and has some clinical value.