Özet:

Introduction/Objective:IVF-ET is intended to compare the effectiveness of the GnRH antagonist and agonist protocols of the 1000 cycles applied. Tools and Methods: 1,000 cycles have been included in the study, 283 of these cycles have been applied to the agonist protocol, and 717 to the antagonist protocol. Both protocol groups are compared in terms of demographic characteristics, treatment characteristics, pregnancy rates. Results:Agonist protocol group ?coasting? The application and OHSS development were statistically high (p<0,001).The cycle cancellation rates were statistically significantly high in the antagonist protocol group (p<0,001). The chemical pregnancy rate per cycle in the agonist protocol group is 40.3%, while in the antagonist protocol group it is 28.5%. The clinical pregnancy rate in the Agonist protocol group was 31.4%, the continuous pregnancy rate was 27.2%, while the antagonist group was 27.2 and 25.1%, respectively (p=0.179 and p=0.115). The rate of chemical pregnancy per transfer in the agonist and antagonist protocol group was 42.1% in the agonist protocol group and 32.8% in the antagonist protocol group. In the Agonist group of protocols, this ratio was statistically significantly high (p=0,08). In the Agonist protocol group, the clinical pregnancy rate per transfer was 32.8%, the continued pregnancy rate was 28.4%. In the antagonist group of protocols, these rates were respectively 31.4%, 28.9%. In both protocol groups, this height in the agonist group was not statistically meaningful (respectively p=0,660 and p=0,873). Our study found the effects of both protocol groups on clinical pregnancy similar (OR=0,814, 95% CI=0,603-1,099;p=0,18). On chemical pregnancy, the GnRH agonist protocol was found more successful (OR = 1,696, 95% CI = 1,272-2,262;p<0,001). With regard to its effects on continuing pregnancy, the effects of both protocols were similar (OR=1,115, 95% CI=0,817-1,523 ;p=493). GnRH agonist and GnRH antagonist protocol groups found similar clinical and continued pregnancy rates. Due to the long stimulation time of the GnRH agonist protocol and the frequency of OHSS observation, the selection of the GnRH antagonist protocol in recent years has been preferred primarily in treatments.

Anahtar Kelimeler:

Özet:

Objective:Aim of this study is to compare effectiveness of gonadotrophin releasing hormone (GnRH) agonist in-vitro fertilization(IVF) cycles compared to GnRH antagonist IVF cycles Methods:In all, 1000 fresh cycles were used in analysis.GnRH agonist and GnRH antagonist were compared. Primary outcome measure of the study was ongoing pregnancy rate after 12 weeks of gestation. Results:Agonist cycles had significantly more cases of coasting and OHSS (p<0,001). Cycle cancellation rates were more common in GnRH antagonist group (p<0,001).Biochemical pregnancy rates were higher in the GnRH agonist group (40.3% vs 28.5%) (p<0,001). Clinical pregnancy and ongoing pregnancy rates were higher in the GnRH agonist group (31,4% and 27,2% respectively) compared to GnRH antagonist group (27,2%, and 25,1% respectively)(p=0,179 and p=0,115 ). Biochemical pregnancy rates per cycle were higher in the GnRH agonist group (42,1% vs 32,8%) (p=0,008). Clinical pregnancy and ongoing pregnancy rates per cycle in GnRH agonist group (32,8% and 28,4%) were higher compared to GnRH antagonist group (31,4% and 28,9%,) (p=0,660) We found no significant difference in clinical pregnancy between groups(OR=0,814, 95% CI=0,603-1,099;p=0,18). GnRH agonist protocol was more succesful in biochemical pregnancy OR =1,696, 95 %CI=1,272-2,262;p<0,001). The ongoing pregnancy rates were similar between groups (OR=1,115, 95% CI=0,817-1,523 ;p=493). Conclusion:GnRH agonist cycles have longer induction duration, and higher rates of OHSS, and similar pregnancy rates with antagonist cycles. GnRH agonist use in IVF cycles is falling behind GnRH antagonist use in contemporary practice.