Classical Antagonist Protocol In Comparison With Agonist Stop Protocol In PCOS Women Undergoing ICSI Trial: A Randomized Controlled Trial

Abstract

Background and aim: Polycystic ovary syndrome (PCOS) is distinguished by hyperandrogenism, oligomenorrhea, and a cystic ovarian morphology. Ovarian hyperstimulation syndrome (OHSS) is more likely to occur in women with PCOS who undergo IVF. The utilization of hCG to begin the ovum's ultimate maturation is a significant mechanism in OHSS . The ESHRE guidelines recommend that in women with PCOS undergoing ICSI/IVF treatment the gonadotrophine releasing hormone antagonist protocol is optimal or superior to gonadotrophin releasing agonist long protocol. In this study we aimed to Compare pregnancy rate between classical (standard) antagonist protocol to agonist stop/antagonist protocol in women with PCOS undergoing ICSI as a primary outcome. Patients and Methods: It was an open randomized, parallel treatment clinical trial comparing classical antagonist protocol to agonist stop/antagonist protocol in PCOS women undergoing ICSI cycles. A total number of 150 participants divided randomly into 2 groups; Group (A): “classical antagonist protocol” group (n=75) while Group (B): “agonist stop/antagonist protocol” group (n= 75). Results: There was no significant variation in the pregnancy rate amongst the 2 groups. Duration of stimulation was also significantly longer among group B than group A. There was not a statistically significant distinction in OHSS amongst both groups, number of oocytes collected, number of embryos transferred and fertilization rate. Conclusion: In PCOS women undergoing ICSI/IVF treatment, the GnRH antagonist protocol is equally effective as or more so than the gonadotrophin releasing agonist stop protocol. The benefits of both procedures can still be utilized.