Long GnRH Agonist versus GnRH Antagonist Protocols in Women with Endometrioma and Good Ovarian Reserve Undergoing IVF/ICSI Cycles

The best ovarian stimulation protocol in the case of endometrioma-related infertility is still debated. In this study, we examined the effect of two ovarian stimulation protocols on in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) outcome in patients with good ovarian reserve suffering from endometrioma. In a retrospective study, 101 women with endometrioma and good ovarian reserve were recruited. Women received either gonadotropin-releasing hormone (GnRH) agonists (n=65) or GnRH antagonists (n=36) in an IVF or ICSI cycle. Clinical and chemical pregnancy rate, live birth rate, implantation rate, fertilization rate and fertilization proportion, as well as miscarriage rate, were evaluated in both groups. Chemical (25% vs. 28.6%), clinical (19.6% vs. 25%), and live birth rates (19.6% vs. 25%) as well as implantation rate (11.7% vs. 15%) were not significantly different between the two groups. Miscarriage rate, fertilization rate and fertilization proportion were similar in the two groups. GnRH antagonist protocol with the main advantages of short duration and lower cost of treatment could be applied in infertile patients with endometrioma and good ovarian reserve.