ICSI cycles in women over 40 years: analysis of 3 different ovarian stimulation protocols

Purpose: To compare the clinical and laboratory outcomes of GnRH agonist stop, aromatase inhibitor/flexible antagonist and ultrashort flare GnRHa/flexible GnRH antagonist protocols in women (40-44) years undergoing ICSI. Patient(s): the outcomes of controlled ovarian stimulation in 109 infertile patients between 40 and 44 years were analyzed. A GnRH agonist stop protocol was used in 40 patients; aromatase inhibitor/flexible antagonist in 36 and ultrashort flare GnRHa/flexible antagonist in 33 patients. Result(s): The duration of stimulation and the number of ampules of gonadotropins were significantly higher in GnRH agonist stop protocol. Endometrial thickness was significantly higher in aromatase inhibitor/flexible antagonist protocol. No significant difference with respect to the number and quality of oocytes, fertilized oocytes and good quality embryos. Pregnancy/retrieval (38.9%, 20.6% and 25%) and ongoing pregnancy rates (33.3%, 14.7% and 18.8%) were non-significantly higher in GnRH agonist stop protocol. Conclusion(s): Pregnancy/retrieval and ongoing pregnancy rates are comparable among the three protocols with GnRH agonist stop protocol having non-significantly higher rates. (C) 2018 Middle East Fertility Society. Production and hosting by Elsevier B.V.