Antagonist protocol in oocyte-donors egg sharing programme is equally efficient as the agonist protocol in patients of same age group

Abstract

OBJECTIVE: The study was undertaken to determine the efficacy of the antagonist protocol in a oocyte donor – recipient egg sharing programme and compare it with the agonist protocol used in regular infertility patients.DESIGN: Retrospective study involving oocyte donors and regular infertility patients comparing antagonist and agonist protocols during 1/10/2007 till 31/03/2008.MATERIALS AND METHODS: 32 women with proven fertility were recruited as oocyte donors (aged between 20 to 30years). Antagonist protocol was used for their ovarian stimulation (187.5 – 200 IU r-FSH from day 2; antagonist 0.25mg per day, flexible protocol). Recipients (n=70) were prepared with estradiol valerate and micronized progesterone. Every recipient received at least 7 mature eggs retrieved from the donors. 79 patients (aged between 20 to 30 years) underwent ovarian stimulation using agonist protocol (down regulation with Luprolide acetate 0.5 mg and ovarian stimulation with 200- 225 IU r-FSH). Three embryos were transferred on day-2 after oocyte collection. Pregnancy was defined as b hCG of ≥100 mIU/ ml 15 days after embryo transfer (ET).RESULTS: The average age (26.7 and 27.2 years), average number of eggs (18 and 15), % of mature eggs (90 and 87%), normal fertilization rate (77 % apiece), cleavage rate (97.5 and 98.7%), % useable embryos (97 and 96%) and four cell-grade1 embryos (53 and 56%) are comparable in the oocyte-donors (antagonist protocol) and the regular infertility patients (agonist protocol). The number of patients covered for embryo transfer (70 and 79), pregnancy rate per embryo transfer (34 and 32%), multiple pregnancy rate (29 % apiece) and the implantation rate per embryo (16.3 and 15%) are also not significantly different in oocyte- donor (antagonist protocol) and regular patients (agonist protocol). By sharing eggs from donors, 70 ET could be carried out from 32 donor stimulations [2.2 recipients / donor] giving a pregnancy rate of 75% per donor.CONCLUSIONS: This study shows that in the same age group the antagonist protocol yields almost similar results compared to agonist protocol. Further, sharing of eggs from donor helps twice the number of recipients per donor without compromising the pregnancy rate. OBJECTIVE: The study was undertaken to determine the efficacy of the antagonist protocol in a oocyte donor – recipient egg sharing programme and compare it with the agonist protocol used in regular infertility patients. DESIGN: Retrospective study involving oocyte donors and regular infertility patients comparing antagonist and agonist protocols during 1/10/2007 till 31/03/2008. MATERIALS AND METHODS: 32 women with proven fertility were recruited as oocyte donors (aged between 20 to 30years). Antagonist protocol was used for their ovarian stimulation (187.5 – 200 IU r-FSH from day 2; antagonist 0.25mg per day, flexible protocol). Recipients (n=70) were prepared with estradiol valerate and micronized progesterone. Every recipient received at least 7 mature eggs retrieved from the donors. 79 patients (aged between 20 to 30 years) underwent ovarian stimulation using agonist protocol (down regulation with Luprolide acetate 0.5 mg and ovarian stimulation with 200- 225 IU r-FSH). Three embryos were transferred on day-2 after oocyte collection. Pregnancy was defined as b hCG of ≥100 mIU/ ml 15 days after embryo transfer (ET). RESULTS: The average age (26.7 and 27.2 years), average number of eggs (18 and 15), % of mature eggs (90 and 87%), normal fertilization rate (77 % apiece), cleavage rate (97.5 and 98.7%), % useable embryos (97 and 96%) and four cell-grade1 embryos (53 and 56%) are comparable in the oocyte-donors (antagonist protocol) and the regular infertility patients (agonist protocol). The number of patients covered for embryo transfer (70 and 79), pregnancy rate per embryo transfer (34 and 32%), multiple pregnancy rate (29 % apiece) and the implantation rate per embryo (16.3 and 15%) are also not significantly different in oocyte- donor (antagonist protocol) and regular patients (agonist protocol). By sharing eggs from donors, 70 ET could be carried out from 32 donor stimulations [2.2 recipients / donor] giving a pregnancy rate of 75% per donor. CONCLUSIONS: This study shows that in the same age group the antagonist protocol yields almost similar results compared to agonist protocol. Further, sharing of eggs from donor helps twice the number of recipients per donor without compromising the pregnancy rate.