Mini-dose GnRH-a long versus short protocol in patients ≥35 years old undergoing in vitro fertilization

Abstract

Purpose: To compare the clinical result of mini-dose GnRH-a long protocol with short protocol in older patients undergoing IVF.

Materials and methods: This was a retrospective study. Four hundred and sixty-one women aged above 35-year-old in first cycle were assigned to two groups: GnRH-a short protocol (n = 359); and mini-dose GnRH-a long protocol (n = 102). Both groups were divided based on their age, into groups over and under 38 years old. Primary outcome include live birth rate per started cycle. Other clinical outcomes were good-quality embryo rate, clinical pregnancy rate.

Results: Patients treated with mini-dose GnRH-a protocol and those treated with short protocol showed similar live birth rate. In the mini-dose long protocol group aged 35–38 years old, patients showed significantly thicker endometrium at the day of hCG administration, higher number of good embryos obtained and higher good-quality embryo rate (56.3% versus 46.5%) compared with short protocol. The implantation rate and clinical pregnancy rate were higher versus short protocol group, but this result was not statistically significant.

Conclusion(s): Mini-dose GnRH-a long protocol for older women is at least as effective as short protocol, especially in patients aged 35–38 years, with a better good-quality embryo rate and higher number of good embryos obtained, therefore mini-dose GnRH-a long protocol can be considered as an alternative protocol for patients above 35 years age.

• Advanced reproductive age
• GnRH agonist
• in vitro fertilization
• long protocol
• mini-dose
• short protocol