IVF Outcomes, PCOS GnRH Antagonist and GnRH Agonist IVF/ICSI Cycles
Conditions
Brief summary
This randomized clinical trial included 60 infertile women diagnosed with PCOS undergoing ICSI cycles using a GnRH antagonist protocol. Participants were randomly allocated into two equal groups: the pretreatment (Cyclo) group (n = 30), which received oral estradiol valerate (Cycloprogynova) 4 mg/day during the luteal phase before stimulation, and the control group (n = 30), which did not receive pretreatment. Primary outcomes included follicular synchronization, total gonadotropin dose, duration of stimulation, and ovarian response. Secondary outcomes included mature oocyte yield, fertilization rate, embryo quality, and pregnancy outcomes.
Detailed description
Controlled ovarian stimulation was initiated on day 2 of the menstrual cycle using individualized gonadotropin doses according to age, BMI, AMH, and AFC. GnRH antagonist was initiated once at least one follicle reached 13 mm diameter. Ovulation trigger was administered when at least five follicles reached ≥17 mm. Add reference Oocyte retrieval was performed 36 hours after trigger under transvaginal ultrasound guidance. Women in the pretreatment group received oral estradiol valerate (Cycloprogynova) 4 mg/day during the luteal phase from day 21 of prior cycle To day 2 of COH ovarian stimulation cycle while women in the control group underwent standard GnRH antagonist stimulation without estradiol pretreatment.
Interventions
Controlled ovarian stimulation was initiated on day 2 of the menstrual cycle using individualized gonadotropin doses according to age, BMI, AMH, and AFC. GnRH antagonist was initiated once at least one follicle reached 13 mm diameter.
oral estradiol valerate (Cycloprogynova) 4 mg/day during the luteal phase from day 21 To day 2 preceding ovarian stimulation cycle
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 37 Years
Healthy volunteers
No
Inclusion criteria
* PCOS was defined by the presence of at least two of the following: 1. oligo or anovulation, 2. clinical or biochemical hyperandrogenism, and 3. polycystic ovarian morphology on ultrasound (≥12 antral follicles 2-9 mm in diameter and/or ovarian volume \>10 mL). All participants had undergone failed ovulation induction or were candidates for IVF/ICSI due to male factor infertility.
Exclusion criteria
* previous ovarian surgery * endometriosis * known chromosomal abnormalities * untreated thyroid disease * body mass index (BMI) \> 35 kg/m² * basal FSH \>12 IU/L * use of hormonal medications within 3 months prior to the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Follicular synchronization | at day 8 of stimulation | Mean follicle diameter and within patient standard deviation |
Countries
Egypt
Contacts
PRINCIPAL_INVESTIGATORAhmed Maged
Cairo University
Outcome results
None listed