[Controlled ovarian stimulation protocols in endometriosis patients: with antagonist or agonist?]

Ya Yu, Yu Y, Kai Wei, Wei K, Yao Q, Qiuping Yao, Tian Shen, Shen Tian, Tian S, Kun Liang, Liang K, Zhou L, Liming Zhou, Wang L, Liping Wang, Min Jin, Jin M
Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2019 · vol. 48(2) , pp. 165–173 · doi:10.3785/j.issn.1008-9292.2019.04.07 · PMID:31309754 · PMC8800656 · W2973657383
Observational OA: green CC0 ⤵ 4 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

This study compared IVF outcomes in endometriosis patients using antagonist, long agonist, or prolonged agonist protocols, finding the antagonist protocol comparable to agonist protocols, especially for diminished ovarian reserve.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

The paper discusses controlled ovarian stimulation protocols in endometriosis patients, comparing outcomes under antagonist versus agonist approaches for ovarian stimulation. It addresses which protocol is preferable in this patient population, presenting the comparative findings reported in the underlying clinical context. A major limitation explicitly reflected in the presentation is that the article content shown in the provided text is largely administrative and does not include detailed methods, results, or a stated evidence-based limitation. This paper is centrally about endometriosis — it focuses on how antagonist versus agonist controlled ovarian stimulation protocols are managed and compared in endometriosis patients.

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Abstract

OBJECTIVE: To compare laboratory and clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) in patients with endometriosis using antagonist protocol, long agonist protocol or prolonged agonist protocol. METHODS: Totally 313 patients with endometriosis were recruited in Reproductive Centers of the Second Affiliated Hospital of Zhejiang University School of Medicine,Jiaxing Women and Children's Hospital,and Ningbo Women and Children's Hospital from April 2017 to October 2018, including 81 patients treated with antagonist protocol (antagonist group), 148 treated with long agonist protocol (long agonist group) and 84 treated with prolonged agonist protocol (prolonged agonist group). The clinical and laboratory data of the patients were retrospectively analyzed to investigate the effect of ovarian stimulation protocols on the IVF-ET outcomes of patients with endometriosis. RESULTS: The average age in the antagonist group patients was significantly higher than those in the other two groups (all P<0.05),and anti-mullerian hormone (AMH) level and antral follicle numbers were significantly lower than those in the other two groups (all P<0.01). The numbers of average retrieved oocyte, fertilized oocyte and available embryo in the antagonist group were significantly lower than those in the long agonist group (all P0.05). Fertilization rate and available embryo rate were comparable among the three groups (all P>0.05). Considering analysis per cycle with embryo transfer, the human chorionic gonadotrophin (HCG) positive rate, clinical pregnancy rate and total implantation rate showed no significant difference among the three groups (all P>0.05). The implantation rate after fresh embryo transfer in the antagonist group was lower than that in the long agonist group (P0.05). While the implantation rate of freeze-thaw embryo transfer showed a higher trend in the antagonist group, but there was no significant difference (P>0.05). The patients were further divided into diminished and normal ovarian reserve subgroups, the per cycle with embryo transfer, the HCG positive rate, clinical pregnancy rate and total implantation rate still showed no significant difference between two subgroups (all P>0.05), no matter in which ovarian stimulation protocol groups. Besides, in women with diminished ovarian reserve, the available embryo rate in antagonist group was significantly higher than that in the long agonist group (P<0.05). The amount and duration of Gn application in antagonist group were significantly lower than those in long and prolonged agonist groups (all P<0.05). CONCLUSIONS: Patients with endometriosis who used the antagonist protocol in IVF procedure could reduce the cost and time of Gn treatment, when combined with frozen-embryo transfer strategy the antagonist protocol has comparable clinical pregnancy outcome with long or prolonged agonist protocol, especially in those with diminished ovarian reserve, the higher available embryo rate can be achieved.
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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Ovulation Induction Ovulation Induction Ovulation Induction Embryo Transfer Embryo Transfer Female Female Fertilization in Vitro Fertilization in Vitro Humans Humans Pregnancy Pregnancy Retrospective Studies Retrospective Studies

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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