O-280 Cycle programming prior to IVF

Abstract

Abstract The GnRH antagonist protocol has become increasingly popular for ovarian stimulation (OS), thanks to a number of advantages over the long GnRH agonist protocol: a reduced duration of stimulation with lower consumption of gonadotrophins and a lower rate of the ovarian hyperstimulation syndrome (OHSS), without any compromise in delivery rates. Despite the clear benefits associated with the GnRH antagonist protocol, the long GnRH agonist protocol allows a more flexible and controlled schedule of oocyte retrievals: this is important both for the patient, who wants to undergo reproductive treatment at her own convenience, and for the IVF clinic. Cycle scheduling allows not only a more equal distribution of the work load, but can also avoid the vast majority of oocyte retrievals during weekend days. To circumvent this shortcoming, the use of oral contraceptive pills (OCP) has been advocated as a programming method for IVF cycles using the GnRH antagonist protocol. Although the published evidence is clear about the negative impact of this method of programming, it is still widely used over the globe. Nevertheless, there are other possibilities of scheduling the oocyte retrievals, such as the use of estradiol, a pretreatment of GnRH antagonists, and other approaches. These options will be highlighted in the lecture.