Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
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Abstrakt

The Role of GnRH-Analogues used in Elderly (>38 yrs) Patients Undergoing Controlled Ovarian Hyperstimulation for IVF

Jacob Ashkenazi, Itai Bar-Hava, Simion Meltcer, Jacob Rabinson, Eyal Y Anteby and Raoul Orvieto

Objectives: To examine the influence of type of GnRH-analogue used, on reproductive outcome of elderly patients (> 38 years old) undergoing controlled ovarian hyperstimulation (COH) for IVF.

Patients and Methods: We studied 2436 consecutive cycles, 1369 in the agonist group and 1067 in the antagonist group. Infertility-treatment-related variables and pregnancy rates were compared between young (<38 years) and elderly patients and between those undergoing the GnRH-agonist or antagonist COH protocols.

Results: While a significantly higher pregnancy rate was observed in young patients undergoing the GnRH-agonist as compared to the GnRH-antagonist COH protocols (30.1% vs 21.1%, respectively; p<0.001), no difference was demonstrated in elderly patients.

Conclusions: The long GnRH agonist suppressive protocol has a clear advantage over the GnRH antagonist in young patients with favorable outcome- a priori, but not in elderly patient undergoing COH for IVF.