April 2016 · Volume 5 · Issue 4 Page 1134 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Khalifa EEAE et al. Int J Reprod Contracept Obstet Gynecol. 2016 Apr;5(4):1134-1139 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Fixed gonadotropin-releasing hormone antagonist protocol versus gonadotropin-releasing hormone agonist long protocol in patients with polycystic ovary syndrome treated for intracytoplasmic sperm injection cycles Emad Eldin Abd Elrahman Khalifa, Yasser Ibrahim Orief, Tamer Hanafy Mahmoud Said*, Doaa Abd Allah Abd Elmaksoud INTRODUCTION Polycystic ovary syndrome (PCOS) is the most common cause of an ovulatory infertility characterized by chronic anovulation and hyperandrogenism. 1 The current diagnosis of PCOS is defined according to Rotterdam criteria. Diagnosis depends on two of the following criteria only; (1) clinical and/or biochemical evidence of hyperandrogenism with exclusion of other causes of androgen excess; (2) oligo or anovulation; (3) polycystic ovaries by ultrasound (ovarian volume >12cc with 10 or more follicles 2-8mm in diameter, arranged around echodense stroma). 2 PCOS is also reported to be associated with obesity, insulin resistance and type 2 diabetes, dyslipidaemia, hypertension, cardiovascular disease and late menopause endometrial carcinoma. 6-10 Frequently encountered endocrine features are hypersecretion of LH, hyperandrogenemia and compensatory hyperinsulinaemia. 3,4 The optimal infertility treatment for PCOS women is still a matter of Department of Obstetrics & Gynaecology, Faculty of Medicine, Alexandria University, Egypt Received: 02 February 2016 Accepted: 01 March 2016 *Correspondence: Dr. Tamer Hanafy Mahmoud Said, E-mail: tamerhanafy74@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) are at risk of developing ovarian hyperstimulation syndrome (OHSS) during ovarian stimulation. Use of GnRH antagonist in the general sub fertile population is associated with lower incidence of (OHSS) than agonists and similar probability of live birth but it is unclear. Our Objective was to compare the fixed GnRH antagonist and GnRH agonist long protocols in patients with PCOS undergoing IVF. Methods: In this randomized controlled trial (RCT), 200 patients with PCOS were randomly allocated in two groups: long GnRH (n = 100) and fixed GnRH antagonist protocol (n = 100). Results: There is significant difference was observed in chemical pregnancy rate (46.0% versus 31.0%), and clinical pregnancy rate (43.0% versus 29.0%) in agonist and antagonist protocols, respectively. Duration of stimulation was significantly higher in agonist group (13.58 versus 12.381 days), respectively. Total number of ampoules of gonadotrophin is comparable in both groups (t=1.914, p=0.057). Conclusions: The use of GnRH antagonists is more advantageous than GnRH agonists in relation to shorter duration of stimulation thus allowing a reduction in the treatment time that makes COS less costly and better patient compliance. In this study GnRH agonist shows higher pregnancy rate than antagonist, so larger studies needed to clarify their roles. Keywords: Gonadotrophin-releasing hormone agonist, Gonadotrophin-releasing hormone antagonist, In-vitro fertilization, Polycystic ovarian syndrome DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160872