PROSPECTIVE RANDOMIZED STUDY OF AN ULTRASHORT GONADOTROPIN-RELEASING-HORMONE AGONIST VERSUS A MODIFIED SUPPRESSION PROTOCOL FOR OVARIAN STIMULATION IN INTRACYTOPLASMIC SPERM INJECTION CYCLES

To compare oocyte quality and clinical outcome after an ultrashort or a modified suppression gonadotrophin-releasing hormone agonist (GnRHa) protocol for ovarian stimulation in intracytoplasmic sperm injection (ICSI) cycles, we conducted a prospective randomized study of 60 conse cutive couples with severe male infertility admitted for their first i n-vitro fertilization (IVF) and ICSI attempt, More cycles were cancell ed after the ultrashort protocol (8/30) than after the modified suppre ssion protocol (3/30), although the difference was not significant, Th ere were no cases of severe ovarian hyperstimulation syndrome (OHSS) i n the ultrashort group compared to three cases in the suppression grou p, The percentage of mature metaphase II oocytes recovered in both gro ups was similar (88 versus 86%), as were the fertilization or cleavage rates after ICSI, In the ultrashort group, a total of 64 embryos was replaced in 22 transfers (mean 2.9 embryos per transfer), resulting in three first trimester abortions and seven deliveries, In the suppress ion group, 11 deliveries were achieved after transfer of a total of 75 embryos in 27 patients (mean 2.8 embryos per transfer), In conclusion , there was no apparent difference between the two GnRHa protocols in terms of oocyte quality and clinical outcome, However, because of the lower rate of severe OHSS, in our study the ultrashort protocol was mo re appropriate for ovarian stimulation in ICSI cycles than the modifie d suppression protocol.