In ICSI cycle's controlled ovarian hyperstimulation is an important parameter of the success rates.
Premature LH surge may complicate ovarian stimulation and decrease the pregnancy rate, suppression of endogenous LH can be achieved by GnRH antagonist protocols.
GnRH antagonists results in immediate down regulation of pituitary gland, thus allowing for shorter period of suppression, reduced duration of stimulation and associated with lower incidence of OHSS.
Advantages of pretreatment are more synchronous follicular development, higher number of oocytes, programming for cycle start and programming oocyte retrieval day.
Advantages of E2 versus OCPs are, duration of pretreatment is shorter, a good alternative for patients who have objections to or present contraindications for taking OCPs, E2 doesn't affect the fertility potential during the cycle preceding ovarian stimulation.
Follicular phase estradiol scheduling does not seem to increasegonadotropin consumption or hamper clinical outcome.
AIM OF THE WORK:
The aim of the work was to compare pretreatment with OCPs with pretreatment with follicular estradiol valerate 8mg in antagonist protocol cycles for patients undergoing ICSI.