Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial

Background: Women with low ovarian reserve are the capable part of people who refer to infertility centers, this study compares 2 treatment protocols in cases with low ovarian reserve. Objective: This study aimed to compare the efficacy of gonadotropin-releasing hormone (GnRH) agonist and GnRH-a...

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Main Authors: Zahra Aminimajomerd, Maryam Eftekhar, Nooshin Hatamizadeh, Shahrzad Moeinaddini
Format: Article
Language:English
Published: Shahid Sadoughi University of Medical Sciences 2025-05-01
Series:International Journal of Reproductive BioMedicine
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Online Access:https://knepublishing.com/index.php/ijrm/article/view/18775
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author Zahra Aminimajomerd
Maryam Eftekhar
Nooshin Hatamizadeh
Shahrzad Moeinaddini
author_facet Zahra Aminimajomerd
Maryam Eftekhar
Nooshin Hatamizadeh
Shahrzad Moeinaddini
author_sort Zahra Aminimajomerd
collection DOAJ
description Background: Women with low ovarian reserve are the capable part of people who refer to infertility centers, this study compares 2 treatment protocols in cases with low ovarian reserve. Objective: This study aimed to compare the efficacy of gonadotropin-releasing hormone (GnRH) agonist and GnRH-antagonist protocols in women with diminished ovarian reserve (DOR) in POSEIDON groups 3–4 undergoing in assisted reproductive technology (ART). Materials and Methods: This randomized clinical trial enrolled 158 infertile women with diminished ovarian reserve undergoing ART at the Research and Clinical Center for Infertility, Yazd, Iran from January to October 2024. Women were randomly assigned to either a GnRH-antagonist (n = 84) or a long GnRH-agonist (n = 74). Primary outcomes included clinical pregnancy and secondary outcomes were chemical pregnancy, early abortion rate, ongoing pregnancy, and implantation rate. Results: No significant differences were observed in baseline values between groups. The GnRH-agonist group had a longer stimulation duration (12.23 vs. 10.60 days, p < 0.001) and a higher total gonadotropin dose (4588.84 vs. 3225.67 IU, p < 0.001) compared to the antagonist group. Clinical pregnancy rates (17.8% vs. 15.8%, p = 0.810) and live birth rates (11.1% vs. 13.2%, p = 0.775) were comparable between the agonist and antagonist groups. Conclusion: According to acquired data, the GnRH-antagonist and long GnRH-agonist protocols resulted in similar ART outcomes. The antagonist protocol was associated with shorter stimulation and lower gonadotropin consumption. As a result, the antagonist protocol was found to be more cost effective. Larger studies are needed to confirm these results and determine the optimal protocol for this woman group.
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publisher Shahid Sadoughi University of Medical Sciences
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series International Journal of Reproductive BioMedicine
spelling doaj-art-ce3505f0f89f436b8dd79feb12ed6e822025-08-20T03:22:04ZengShahid Sadoughi University of Medical SciencesInternational Journal of Reproductive BioMedicine2476-41082476-37722025-05-0123310.18502/ijrm.v23i3.18775Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trialZahra Aminimajomerd0Maryam Eftekhar1Nooshin Hatamizadeh2Shahrzad Moeinaddini3Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, YazdResearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, YazdResearch and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.Research and Clinical Center for Infertility Background: Women with low ovarian reserve are the capable part of people who refer to infertility centers, this study compares 2 treatment protocols in cases with low ovarian reserve. Objective: This study aimed to compare the efficacy of gonadotropin-releasing hormone (GnRH) agonist and GnRH-antagonist protocols in women with diminished ovarian reserve (DOR) in POSEIDON groups 3–4 undergoing in assisted reproductive technology (ART). Materials and Methods: This randomized clinical trial enrolled 158 infertile women with diminished ovarian reserve undergoing ART at the Research and Clinical Center for Infertility, Yazd, Iran from January to October 2024. Women were randomly assigned to either a GnRH-antagonist (n = 84) or a long GnRH-agonist (n = 74). Primary outcomes included clinical pregnancy and secondary outcomes were chemical pregnancy, early abortion rate, ongoing pregnancy, and implantation rate. Results: No significant differences were observed in baseline values between groups. The GnRH-agonist group had a longer stimulation duration (12.23 vs. 10.60 days, p < 0.001) and a higher total gonadotropin dose (4588.84 vs. 3225.67 IU, p < 0.001) compared to the antagonist group. Clinical pregnancy rates (17.8% vs. 15.8%, p = 0.810) and live birth rates (11.1% vs. 13.2%, p = 0.775) were comparable between the agonist and antagonist groups. Conclusion: According to acquired data, the GnRH-antagonist and long GnRH-agonist protocols resulted in similar ART outcomes. The antagonist protocol was associated with shorter stimulation and lower gonadotropin consumption. As a result, the antagonist protocol was found to be more cost effective. Larger studies are needed to confirm these results and determine the optimal protocol for this woman group. https://knepublishing.com/index.php/ijrm/article/view/18775Ovarian reserveOvarian stimulationIn vitro fertilizationART
spellingShingle Zahra Aminimajomerd
Maryam Eftekhar
Nooshin Hatamizadeh
Shahrzad Moeinaddini
Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
International Journal of Reproductive BioMedicine
Ovarian reserve
Ovarian stimulation
In vitro fertilization
ART
title Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
title_full Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
title_fullStr Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
title_full_unstemmed Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
title_short Evaluation of gonadotropin-releasing hormone agonist and antagonist protocols on pregnancy outcomes in POSEIDON groups 3 and 4: A randomized controlled trial
title_sort evaluation of gonadotropin releasing hormone agonist and antagonist protocols on pregnancy outcomes in poseidon groups 3 and 4 a randomized controlled trial
topic Ovarian reserve
Ovarian stimulation
In vitro fertilization
ART
url https://knepublishing.com/index.php/ijrm/article/view/18775
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