Impact of GnRH Agonists and GnRH Antagonists on Embryo Quality, Endometrial Thickness and Pregnancy Rate in In-vitro Fertilization

  • Haroon Latif Khan Prof, Embryologist & CEO, Lahore Institute of Fertility and Endocrinology (LIFE) Pakistan
  • Yousuf Latif Khan Prof and Consultant Endoscopic Surgeon, Department of Obstetrics & Gynecology, Hameed Latif Hospital, Lahore
  • Saba Sardar Prof and Consultant Endoscopic Surgeon, Department of Obstetrics & Gynecology, Hameed Latif Hospital, Lahore
  • Abdul Rahman Khawaja Research Consultant, LIFE research cell, Hameed Latif Hospital, Lahore
Keywords: Endometrial thickness, GnRH agonist (long), GnRH antagonist (short), Oocytes, Ovarian stimulation, Pregnancy rate, Uterine endometrium


Objective: To compare the effects of GnRH agonists (long protocol) and GnRH antagonists (short protocol) on embryo quality, endometrial thickness (ET) and pregnancy rate in human in vitro fertilization (IVF).
Subjects & Methods: In this quasi experimental study 237 patients underwent short protocol and 175 long protocol of IVF. hCG was administrated when 2 or more follicles reached the size of 18mm. After 34-36 hours’ oocytes were retrieved transvaginally. ET was carried out after 3-5 days under ultrasound guidance. Rising β-hCG concentration confirmed the diagnosis of pregnancy.
Results: There was no significant difference in proportion of primary and secondary sub fertility between the two groups. Regarding female age, embryo quality and endometrial thickness no significant difference was found between two groups. Number of attempts, no of oocytes, fertilization & cleavage rate, maturation of oocytes and embryos transferred were significantly associated with both long and short protocols.
Conclusion: Ongoing research in assisted reproductive technology has identified some issues which are important from the patient point of view such as ovarian hyper stimulation and safe successful pregnancy. This study shows that pregnancy rate is better with long protocol but that is not statistically significant. More studies should be designed with increase power for suitable comparison of long GnRH agonist protocols with short GnRH antagonist protocols. 

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