Background: Worldwide, ovarian stimulation for Intracytoplasmic Sperm Injection (ICSI) uses GnRH analogues, agonists, and antagonists. They control pituitary activity to prevent LH surges and optimize oocyte retrieval. The consequences of advances on oocyte quality and embryo development are uncertain. GnRH agonists desensitize pituitary GnRH receptors gradually, while antagonists immediately decrease gonadotropin release. Oocyte and embryo quality and development, as well as mother age, hormonal condition, and infertility duration, have been examined to affect ICSI success.
Objectives: To examine the effects of the multiple-dose GnRH antagonist protocol on egg, embryo, and embryo development in IVF/ICSI cycles compared to the long protocol.
Patients and Methods: Two hundred and thirty two patients were included in this retrospective study. It was conducted in Division of Assisted Reproduction, Department of Obstetrics and Gynecology, South Valley University, Tanta University, and private centers. It included patients in the period from July 2017 to December 2022. Patients' data, stimulation protocols, oocytes and embryo qualities were assessed and pregnancy rates. Patients were allocated according to stimulation protocol into agonist and antagonist groups. Data were gathered and analyzed.
Results: Basal demographic data of both groups was comparable. Gonadotropins dose in both groups were 3899.26 ± 1363.99 IU/ml in antagonist group versus 3737.69 ± 932.26 IU/ml in agonist group (p=0.287). Oocytes numbers, and quality of oocytes were better in agonist protocol but the differences were not significant. Stimulation duration was negatively correlated. Embryo quality was comparable in both groups (p=0.681).
Conclusion: The GnRH agonist regimen had increased mature oocytes with good quality oocytes but differences not reaching clinical significance. Fertilization rates and embryo parameters were similar, however stimulation duration significantly affected oocyte and embryo quality.