Aminimajomerd Zahra, Eftekhar Maryam, Hatamizadeh Nooshin, Moeinaddini Shahrzad
Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Int J Reprod Biomed. 2025 Jun 10;23(3):241-250. doi: 10.18502/ijrm.v23i3.18775. eCollection 2024 Apr.
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.
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).
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.
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.
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.
卵巢储备功能低下的女性是前往不孕不育中心就诊人群中的一部分，本研究比较了两种治疗方案用于卵巢储备功能低下的病例。
本研究旨在比较促性腺激素释放激素（GnRH）激动剂方案和GnRH拮抗剂方案对接受辅助生殖技术（ART）的波塞冬（POSEIDON）3 - 4组卵巢储备功能减退（DOR）女性的疗效。
本随机临床试验纳入了2024年1月至10月在伊朗亚兹德不孕不育研究与临床中心接受ART的158例卵巢储备功能减退的不孕女性。将女性随机分为GnRH拮抗剂组（n = 84）或长效GnRH激动剂组（n = 74）。主要结局包括临床妊娠，次要结局为生化妊娠、早期流产率、持续妊娠和着床率。
两组间基线值未观察到显著差异。与拮抗剂组相比，GnRH激动剂组的刺激持续时间更长（12.23天对10.60天，p < 0.001），促性腺激素总剂量更高（4588.84 IU对3225.67 IU，p < 0.001）。激动剂组和拮抗剂组的临床妊娠率（17.8%对15.8%，p = 0.810）和活产率（11.1%对13.2%，p = 0.775）相当。
根据所获数据，GnRH拮抗剂方案和长效GnRH激动剂方案导致相似的ART结局。拮抗剂方案与更短的刺激时间和更低的促性腺激素消耗相关。因此，发现拮抗剂方案更具成本效益。需要更大规模的研究来证实这些结果并确定该女性群体的最佳方案。
