A comparison between GnRH agonist and antagonist analogs for controlled ovarian stimulation in overweight/obese women with PCOS after ICSI

: polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive age females with a prevalence of 10%. Obesity is one of its characteristic association with a prevalence of 40-60%, usually leads to reduce fertility, lower pregnancy potential and increase pregnancy loss. Aim of the study: to decide the better gonadotropin releasing hormone (GnRH) analogues down regulation protocol for overweight/obese PCOS women by studying ICSI outcome in form of ovarian response, embryos’ quality, pregnancy rate and OHSS development. Material & methods: Forty sub-fertile women with PCOS whom their body mass index (BMI) ≥ 26 were included in the study. Their male partners had mild to moderate impairment in semen quality. All are subjected to COS by GnRH analogues and separated into 2 groups; group 1: down regulated by GnRH antagonist (n=14) and group 2: down regulated by GnRH agonist (n=26). Results: not significant difference between both groups concerning ovarian response. Pregnancy rate was greater and the rate of developing OHSS was lower in GnRH antagonist group with non-significant statistical difference 57.1% vs 38.5% and 0% vs 7.7% respectively. Conclusions: both GnRH antagonist and agonist had the same efficacy when used during COS/ICSI for overweight/obese PCOS, but had lower safety in favor of GnRH antagonist protocol.