A comparative study between agonist and antagonist protocol for ovarian stimulation in art cycles at a rural set up in South Gujarat

Background: Modern infertility practice provides us with several protocols for controlled ovarian hyperstimulation for the ART (Assisted Reproductive Techniques) cycles. The review summarises the clinical characteristics of the protocols using Gonadotrophin Releasing Hormone (GnRH) agonists and antagonists emphasising on the major clinical and laboratory outcomes with each protocol.Methods: A total of 322 cases undergoing ovarian stimulation with agonist and antagonist protocols in ART cycles at a rural set up at Killa Pardi in the year 2014 were studied and their laboratory and clinical outcomes were evaluated.Results: Antagonist group had the maximum number of oocytes retrieved and the mature M2 oocytes, maximum No. of follicles >16 mm on day of HCG, maximum No. of positive pregnancy rates. Agonist group had also a good pregnancy rate with maximum Grade I embryos.Conclusions: Taking all data together, it may be concluded that antagonists and minimal ovarian stimulation with antagonist protocols offer a new treatment regimen in ovarian stimulation that is short, safe, cost effective, well tolerated, optimizing convenience for the patient

A comparative study of pregnancy outcome of sequential versus day 3 versus only blastocyst (day 6) transfer at a single IVF center over one year

Background: The recent introduction of sequential media has refocused attention upon the role of human blastocyst in IVF.  For optimisation of extended cycles, one needs to give importance to all the aspects of treatment cycle like the stimulation regimens, medium composition, endometrial quality and uterine receptivity. This study was done to know the pregnancy outcomes of Day 3 transfer vs Day3/Day 6 transfer vs only Day 6 transfer.Methods: It was a retrospective study in which 342 patients undergoing ICSI were included. 199 women underwent Day 3/Day 6 sequential transfers, 112 underwent only Day 3 transfer and only 30 women were given only Blastocyst i.e. day 6 transfer. Pregnancy outcomes of all the three groups were studied.Results: Sequential transfer was found to give maximum pregnancy rate and highest implantation rate. But it was also associated with highest number of multiple pregnancies.Conclusions: Sequential transfer is a very good efficacious approach in ART cycles if extended media are available as it gave maximum pregnancy rate and implantation rate. However it is associated with multiple pregnancies. Thus the ultimate goal is to have a single blastocyst transfer with better outcomes and lower multiple pregnancy rates