Cost-effectiveness of GnRH antagonist implementation on hCG injection day

Abstract

Objective: To compare the outcomes of antagonist stimulation protocols and to compare the cost effectiveness. Materials and Methods: Between 2011 and December 2017, a total of 354 women who underwent intracytoplasmic sperm injection and controlled ovarian stimulation with antagonist protocols were enrolled in the study. The antagonist implementation on the day of human chorionic gonadotropin (hCG) was continued for 194 of women, whereas the antagonist was stopped 36 hours before in 160 women. The stimulation outcomes of patients and cost-effectiveness of the regimens were compared. Results: There was a significant difference between the groups in terms of number of cryopreserved embryos, mature/immature oocyte ratio, and embryo transfer cancellations (p<0.05). The median value for the mature/immature oocyte ratio was 1.1 (0.2-7.5) and 1 (0.5-15) (p=0.001), and the ET cancellation was 5.3% vs. 1% for group 1 and 2, respectively (p=0.037). There was no difference between the groups in terms of pregnancy rates (p=0.197). Conclusion: No difference was found in the clinical pregnancy rates between the two groups. For this reason, the cessation of antagonist implementation on the day of hCG seems more advantageous in terms of cost-effectiveness and fewer injections.