Optimizing IVF Outcomes in PCOS Patients with GnRH Antagonist Administration from Day 1 of Ovarian Stimulation: A Retrospective Cohort Study

Objectives: Gonadotropin releasing hormone (GnRH) antagonist protocols are preferred in polycystic ovary syn-drome (PCOS) patients undergoing in-vitro fertilization (IVF) as they provide the best combination of flexibility, acceptable outcomes, and safety. Numerous studies have compared outcomes between GnRH agonist long proto-col and standard flexible antagonist protocol. However, there are scant studies investigating effectiveness of an-tagonist administration from day 1 of ovarian stimulation in PCOS patients. Methods: We performed a retrospective cohort study to compare laboratory and clinical outcomes in IVF between standard flexible day 5/day 6 versus day 1 GnRH antagonist protocol in PCOS patients. Results: Our data indicates significantly superior oocyte yield and top-quality embryo proportion in patients with antagonist from day 1. Cumulative clinical pregnancy rates also tended to be superior in this group. Conclusions: Our findings indicate that administration of GnRH antagonists from day 1 of stimulation in PCOS patients undergoing IVF may lead to superior results.