5 secrets of agonist vs antagonist protocol in IVF

Dr. Anshu Jindal (MD, DNB, MNAMS) IVF Specialist & Clinical Director
Jindal Hospital, Meerut in Conversation with Dr. Sonia Malik
(DGO, MD, FICOG, FIAMS) Director Southend Fertility &
IVF Centre, New Delhi
5 secrets of agonist vs antagonist protocol in IVF
Secret-1 Know the mode of action GnRH agonists cause flare up first followed by suppression GnRH antagonist act immediately & cause only suppression.
Secret-2 Select your patients wisely. GnRH agonists are best suited for
• Normoresponders
• Poor responders
• Endometriosis
• FET cycles
• As ovulation trigger in antagonist cycles in hyperresponders.
Secret-3 Individualize the right protocol for GnRH agonists can be given by 3 protocols
• Long protocol utilizes effect suppression
• Short protocol utilizes & lose effect of GnRH agonists
• Ultrashort protocol GnRH antagonists are given by Flexible protocol (preferred) Fixed protocol.
Secret-4 The monitoring of the patient is important problems with agonist protocols.
- Over suppression
- Hyper stimulation
Secret-5 Adverse effects
1 OHSS especially with agonist cycles with HCG trigger
2 Empty follicle syndrome when HCG trigger given is defective or not given properly or if patient selection for agonist ovulation trigger in antagonist protocol is poor.
3 Luteal phase insufficiency seen in both protocols seen esp. more often when agonist trigger is given in antagonist cycles.
Mission: a free, not for profit, non-political platform which shares the latest knowledge embedded in science and facts with reproductive professionals; empowering them in turn to take good care of their patients.
Vision: a collaborative, live educational forum of medical experts for reproductive professionals that assists them on the path of continuous learning and clinical excellence.
As we are aware that digital medium has become a very powerful platform for disseminating knowledge in all fields including our own field of medicine. But sometimes when a doctor tries to access knowledge from the internet, they find themselves inundated by information yet find it hard to apply it in a particular clinical situation. In order to clear that confusion & help them in assimilating that knowledge we at “global art forum” are starting a web series on ‘5 secrets unravelled by our experts’ on various topics of obstetrics, gynaecology & infertility. And who could do it better than you with years of clinical experience.

[@byasadevmishra3135]

THANKS FOR SHARING YOUR KNOWLEDGE AND EXPERIENCE

[@payalgodbole2810]

Nice lecture 😊