The Role of GnRH-Analogues used in Elderly (>38 yrs) Patients Undergoing Controlled Ovarian Hyperstimulation for IVF

Studies comparing GnRH agonist long protocols with GnRH antagonist protocols have yielded conflicting results for pregnancy rate, and have related the lower pregnancy rate observed during GnRH antagonist cycles, to their use in cycles with an unfavorable prognosis a priori, i.e., repeated failures and elderly low responders [2-3]. Moreover, an increasing number of publications have appeared in literature reinforcing the advantages in using GnRH-antagonists over the agonists, including the lack of hypoestrogenism, the shorter treatment duration, the lower gonadotropin requirement, and a reduction in the incidence of severe ovarian hyperstimulation syndrome (OHSS) [4-5].