Comparison Of Different Ovulation Induction Protocols And The Outcome Of ART

ObjectiveTo compare the long term and short term agonist and antagonist protocol for ovulationinduction during IVF/ICSI and compare the outcome of ART using those protocols.Materials and methodsWe did a retrospective data analysis of683cases recruited from specialized infertilitycentre of Jilin University. Out of these,79patients were induced by long term GnRHagonist from previous cycle,497patients with GnRH agonist in the same cycle,36patients with ultra-long term GnRH protocol in which GnRH agonists were used4weeks prior to the treatment cycle,30patients were induced with short term agonistprotocol and41patients were induced with antagonist protocol. Invitro fertilization orintra cytoplasmic sperm injection was done according to the case requirement. Andthe outcome was compared according to the cancellation rate of cycles, doses ofgonadotropin hormone, number of retrieved oocytes, mature oocytes, fertilizedoocytes and transferred embryos, and pregnancy rates. Endocrinological parameterswere evaluated by using Automated Chemiluminescence System (ACS180plus, Ciba,Corning). Statistical analysis was evaluated by using Chi-Square test and ANOVAtest wherever suitable with significance of p<0.05. ResultThere was significant difference within the groups in number of metaphase II,2pronuclear oocytes, number of embryo transferred, fertilization rate and theimplantation rate. However there was no significance between the groups with regardsto OHSS stimulation rate. Fertilization rate and implantation rate weremaximum inthe long term long protocol and least in short protocol group. Cycle cancellation wasmaximum in short protocol group due to no response to stimulation compromisingabout50%of cancelled cycle. However there was no significant differences betweenthe groups as p value was>0.05. Highest clinical pregnancy rate of59.68%could bedemonstrated in long term long agonist group and least in short term agonist protocolgroup. Early pregnancy loss was also seen more in short term agonist group about14.3%. Live birth rate was also comparable between the groups with91.67%,80.5%,100%,66.7%and100%in protocol1through5respectively. However there could befound no significant differences between the groups in clinical pregnancy rate, earlypregnancy loss rate and live birth rate.ConclusionAs a conclusion we have found that while the number of retrieved oocytes, matureoocytes, fertilized oocytes, implantation rate, clinical pregnancy rates were increasing, the cancellation rate of cycles were decreasing significantly in ART cycles induced bylong protocol especially the long term long agonist protocol with respect to the shortterm agonist protocol and the antagonist protocol.