5 secrets of agonist vs antagonist protocol in IVF
ฝัง
- เผยแพร่เมื่อ 30 ก.ย. 2020
- 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.
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Nice lecture 😊