Use of GnRH antagonist for ovarian stimulation in PCOS patients undergoing IVF/ICSI is associated with less total injections and comparable clinical outcome

GnRH antagonists in normal- responder patients

To review the use of GnRH antagonists in normal-responding patients who are undergoing infertility treatment. Review article and case studies.For the normal-responding patient, GnRH antagonist protocols provide equivalent outcomes as GnRH agonist protocols, with the added patient benefit of significantly fewer treatment/injection days. In addition, a decrease or plateau in E(2) on the day after initiation of the GnRH antagonist has no prognostic significance in IVF outcome.For normal-responding patients, a GnRH antagonist can be used in a flexible fashion to achieve high success rates. The lack of correlation between E(2) patterns on the day after initiation of a GnRH antagonist and IVF outcomes supports the concept that no intervention (such as LH add-back) is necessary to guard against an early decrease or plateau during stimulation with recombinant FSH and a GnRH antagonist. Clinicians must consider ovarian physiology and the mechanism of GnRH antagonist action in patient management.