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Evidence summaries

Gonadotrophin-Releasing Hormone (Gnrh) Antagonists for Assisted Conception

GnRH antagonist protocol appears to be effective for assisted conception, with a large reduction in ovarian hyperstimulation syndrome and no difference in live-birth rates compared to the GnRH agonist long protocol. Level of evidence: "B"

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and no blinding in half of the trials).

A Cochrane review [Abstract] 1 included 45 RCTs involving a total of 7 511 participants comparing the GnRH antagonist to the long protocol of GnRH agonist. There was no evidence of a statistically significant difference in live-birth rate in the antagonist group (odds ratio (OR) 0.86, 95% CI 0.69 to 1.08; 9 trials, n=1515). However, there was statistically significant reduction in incidence of ovarian hyperstimulation syndrome with antagonist protocol (RR 0.43, 95% CI 0.33 to 0.57; 29 trials).

    References

    • Al-Inany HG, Abou-Setta AM, Aboulghar M. Gonadotrophin-releasing hormone antagonists for assisted conception. Cochrane Database Syst Rev 2006 Jul 19;3:CD001750 [Review content assessed as up-to-date: 28 February 2010]. [PubMed]

Primary/Secondary Keywords