Reproductive BioMedicine Online
Volume 20, Issue 3 , Pages 314-319, March 2010

Ovarian stimulation in women with high and low body mass index: GnRH agonist versus GnRH antagonist

  • Banu Kumbak

      Affiliations

    • Department of Obstetrics and Gynecology, Yeditepe University Hospital, Istanbul, Turkey
    • Corresponding Author InformationCorresponding author.
    • ,
  • Hande Akbas

      Affiliations

    • ART and Genetics Center, Memorial Hospital, Istanbul, Turkey
    • ,
  • Levent Sahin

      Affiliations

    • Jin-Fer IVF Unit, Diyarbakir, Turkey
    • ,
  • Guvenc Karlikaya

      Affiliations

    • ART and Genetics Center, Memorial Hospital, Istanbul, Turkey
    • ,
  • Hale Karagozoglu

      Affiliations

    • ART and Genetics Center, Memorial Hospital, Istanbul, Turkey
    • ,
  • Semra Kahraman

      Affiliations

    • ART and Genetics Center, Memorial Hospital, Istanbul, Turkey

Received 28 May 2009; received in revised form 21 July 2009; accepted 25 November 2009. published online 21 January 2010.

Declaration: The authors report no financial or commercial conflicts of interest.

Abstract 

This study evaluated women with a high body mass index (BMI) (>40kg/m2) and low BMI (<18kg/m2) undergoing assisted reproduction treatment and determined whether the type of gonadotrophin-releasing hormone (GnRH) analogue used has an impact on cycle parameters and outcome. The study analysed 65 women with high BMI and 118 with low BMI. In the former group, polycystic ovarian syndrome was significantly more prevalent in the agonist long protocol (ALP) group (P=0.01) and gonadotrophin consumption was lower, peak oestradiol concentrations and total number of oocytes retrieved were higher in the ALP group compared with the antagonist (ANT) group. Implantation rate (IR), pregnancy rate (PR) per embryo transfer and early pregnancy loss rate (EPLR) were similar in both stimulation groups, with overall rates of 21.6%, 55.4% and 44.4%, respectively. In women with low BMI, peak oestradiol concentrations, total oocytes retrieved, mature oocytes and transferred embryos were higher in the ALP group compared with ANT group. IR, PR/embryo transfer and EPLR were similar in both groups, with overall rates of 24.3%, 52.5% and 16.1%, respectively. In all patients, no difference was found between ALP and ANT protocols concerning treatment outcome. Contrary to the reasonable EPLR observed in women with low BMI, the high rate found in women with high BMI is remarkable.

Keywords: assisted reproductive treatment, body mass index (BMI), GnRH agonist, GnRH antagonist, morbid obesity, underweight

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 Banu Kumbak received her MD degree in 1996 from Hacettepe University, School of Medicine, and an Obstetrics and Gynaecology speciality degree in 2001 from Istanbul University Cerrahpasa Medical School, Turkey. She has been working in the area of assisted reproductive treatments since 2002. Her special interests are poor responder patients, ovarian stimulation protocols for assisted reproduction cycles and reproductive surgery.

PII: S1472-6483(09)00282-X

doi:10.1016/j.rbmo.2009.11.027

Reproductive BioMedicine Online
Volume 20, Issue 3 , Pages 314-319, March 2010

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