Comparison of GnRH Agonist Long Protocol and Stop GnRH-agonist Protocol in IVF/ICSI Patients at Misurata National Infertility and Diagnostic Center

Abstract

In clinical practice, the main stimulation protocol is frequently employed: the long GnRH agonist protocol. The long protocol involves continuous GnRHa administration starting in the luteal phase, whereas the “stop” protocol entails early discontinuation of GnRHa to enhance ovarian response, particularly in poor responders. This study compared the outcome of GnRH Agonist Long Protocol and Stop GnRH-agonist Protocol in women undergoing IVF/ICSI treatment at Misurata National Infertility and Diagnostic Center. 129 infertile women were recruited, and they were assigned to the long protocol (n=72) and Stop protocol (n=57) groups. Baselines were comparable except for advanced age, AMH level, and AFC, which were lower in the Stop protocol group. Both protocols were adequate in suppressing LH, E2, and AFC. The Long protocol group showed higher E2 activation and AFC after stimulation. Ovarian stimulation parameters like total gonadotropin consumption and days of stimulation were equal; however, the Long protocol group required more recombinant LH and higher E2 levels on hCG day. Embryological outcomes, e.g., obtained oocytes, MII oocytes, fertilization, and pregnancy rates, were comparable between groups, with greater Day 3 transfer in the Long protocol group. The Stop protocol is an appropriate alternative for women with diminished ovarian reserve, offering shorter treatment, diminished estrogen exposure, and comparable clinical outcomes.