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Live-birth rates similar with GnRH agonists, antagonists
Al-Inany HG. Cochrane Database Syst Rev. 2011; doi: 10.1002/14651858.CD001750.pub3.
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In a recent Cochrane Systematic Review, experts concluded that fertility treatment with gonadotropin-releasing hormone antagonists results in similar live-birth rates as gonadotropin-releasing hormone agonists. The researchers previously concluded that women using antagonists were likely to have lower birth-rates than those using agonists.
In 2006, the researchers made conclusions based on data from 27 randomized clinical trials. Now, they evaluated evidence from 45 trials involving 7,511 women.
“This increased amount of data let us get a much better idea of how well the two approaches compare,” Hesham Al-Inany, MD, PhD, professor of obstetrics and gynecology at Cairo University, Egypt, said in a press release.
Al-Inany and colleagues searched electronic databases, relevant publications and reviews, and abstracts from scientific symposia. Their search yielded no statistically significant difference in live-birth rates between gonadotropin-releasing hormone (GnRH) antagonists and GnRH agonists (nine randomized controlled trials: OR=0.86; 95% CI, 0.69-1.08) or ongoing pregnancy (28 randomized controlled trials: OR=0.87; 95% CI, 0.77-1.00). Similar to their findings in 2006, they found a significantly lower incidence of ovarian hyperstimulation syndrome with GnRH antagonists (29 randomized controlled trials: OR=0.43; 95% CI, 0.33-0.57).
“The reduction in ovarian hyperstimulation combined with a comparable live-birth rate mean justifies a move away from the standard GnRH agonist to using GnRH antagonists,” Al-Inany said.
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