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GnRH antagonist versus long agonist protocols in IVF:a systematic review and meta-analysis accounting for patient type

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  • المصدر:
    Lambalk , C B , Banga , F R , Huirne , J A , Toftager , M , Pinborg , A , Homburg , R , van der Veen , F & van Wely , M 2017 , ' GnRH antagonist versus long agonist protocols in IVF : a systematic review and meta-analysis accounting for patient type ' , Human Reproduction Update , vol. 23 , no. 5 , pp. 560-579 .
  • نوع التسجيلة:
    Electronic Resource
  • الدخول الالكتروني :
    https://curis.ku.dk/portal/da/publications/gnrh-antagonist-versus-long-agonist-protocols-in-ivf(c623581b-94fa-426b-94df-961850eaefa5).html
    https://doi.org/10.1093/humupd/dmx017
  • معلومة اضافية
    • Publisher Information:
      2017
    • Added Details:
      Lambalk, C B
      Banga, F R
      Huirne, J A
      Toftager, M
      Pinborg, A
      Homburg, R
      van der Veen, F
      van Wely, M
    • نبذة مختصرة :
      BACKGROUND: Most reviews of IVF ovarian stimulation protocols have insufficiently accounted for various patient populations, such as ovulatory women, women with polycystic ovary syndrome (PCOS) or women with poor ovarian response, and have included studies in which the agonist or antagonist was not the only variable between the compared study arms.OBJECTIVE AND RATIONALE: The aim of the current study was to compare GnRH antagonist protocols versus standard long agonist protocols in couples undergoing IVF or ICSI, while accounting for various patient populations and treatment schedules.SEARCH METHODS: The Cochrane Menstrual Disorders and Subfertility Review Group specialized register of controlled trials and Pubmed and Embase databases were searched from inception until June 2016. Eligible trials were those that compared GnRH antagonist protocols and standard long GnRH agonist protocols in couples undergoing IVF or ICSI. The primary outcome was ongoing pregnancy rate. Secondary outcomes were: live birth rate, clinical pregnancy rate, number of oocytes retrieved and safety with regard to ovarian hyperstimulation syndrome (OHSS). Separate comparisons were performed for the general IVF population, women with PCOS and women with poor ovarian response. Pre-planned subgroup analyses were performed for various antagonist treatment schedules.OUTCOMES: We included 50 studies. Of these, 34 studies reported on general IVF patients, 10 studies reported on PCOS patients and 6 studies reported on poor responders. In general IVF patients, ongoing pregnancy rate was significantly lower in the antagonist group compared with the agonist group (RR 0.89, 95% CI 0.82-0.96). In women with PCOS and in women with poor ovarian response, there was no evidence of a difference in ongoing pregnancy between the antagonist and agonist groups (RR 0.97, 95% CI 0.84-1.11 and RR 0.87, 95% CI 0.65-1.17, respectively). Subgroup analyses for various antagonist treatment schedules
    • الموضوع:
      Female; Fertilization in Vitro/methods; Gonadotropin-Releasing Hormone/administration & dosage; Gonadotropins/metabolism; Humans; Ovarian Hyperstimulation Syndrome/chemically induced; Ovulation Induction/methods; Polycystic Ovary Syndrome/drug therapy; Pregnancy; Pregnancy Rate; article
    • Note:
      English
    • Other Numbers:
      DAV oai:pure.atira.dk:publications/c623581b-94fa-426b-94df-961850eaefa5
      1322710043
    • Contributing Source:
      UNIV OF COPENHAGEN
      From OAIster®, provided by the OCLC Cooperative.
    • الرقم المعرف:
      edsoai.on1322710043
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