Improving the patient's experience of IVF/ICSI: a proposal for an ovarian stimulation protocol with GnRH antagonist co-treatment
Authors: Devroey, Paul; Aboulghar, Mohamed; Garcia-Velasco, Juan; Griesinger, Georg; Humaidan, Peter; Kolibianakis, Efstratios; Ledger, William; Toms, Candido; Fauser, Bart C.J.M.
Source: Human Reproduction, Volume 24, Number 4, 14 April 2009 , pp. 764-774(11)
Publisher: Oxford University Press
Abstract:Patients undergoing IVF/ICSI frequently experience substantial treatment burden, risk and psychological distress. These three related elements contribute to a negative patient experience that can lead to treatment discontinuation if pregnancy is not achieved. One approach to minimize these factors is the use of protocols designed to achieve high term, singleton birth rates per IVF treatment started, while improving the patient's welfare. Gonadotrophin-releasing hormone (GnRH) antagonists may be suitable for inclusion in such a protocol. In clinical trial data and meta-analyses, treatment with these agents is associated with similar live birth rates but reduced treatment burden (duration and side effects) and less risk of ovarian stimulation syndrome, compared with GnRH agonist long protocols. GnRH antagonists may also be associated with reduced psychological distress compared with agonists, but so far, the evidence for this is inconclusive. To facilitate the implementation of treatments that optimize the patient's experience, a simple GnRH antagonist protocol for use in predicted normal responders is proposed.
Document Type: Opinion
Publication date: 14 April 2009
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.