Long GnRH Agonist versus GnRH Antagonist Protocols in Women with Endometrioma and Good Ovarian Reserve Undergoing IVF/ICSI Cycles

Background: The best ovarian stimulation protocol in the case of endometrioma-related infertility is still debated. In this study, we examined the effect of two ovarian stimulation protocols on in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI) outcome in patients with good ovarian reserve suffering from endometrioma. Methods: In a retrospective study, 101 women with endometrioma and good ovarian reserve were recruited. Women received either gonadotropin-releasing hormone (GnRH) agonists (n=65) or GnRH antagonists (n=36) in an IVF or ICSI cycle. Clinical and chemical pregnancy rate, live birth rate, implantation rate, fertilization rate and fertilization proportion, as well as miscarriage rate, were evaluated in both groups. Results: Chemical (25% vs. 28.6%), clinical (19.6% vs. 25%), and live birth rates (19.6% vs. 25%) as well as implantation rate (11.7% vs. 15%) were not significantly different between the two groups. Miscarriage rate, fertilization rate and fertilization proportion were similar in the two groups. Conclusion: GnRH antagonist protocol with the main advantages of short duration and lower cost of treatment could be applied in infertile patients with endometrioma and good ovarian reserve.