Clinical application and economic analysis of gonadotropin-releasing hormone antagonist protocol in patients with decreased ovarian reserve

Objective To investigate the clinical application and cost effectiveness of gonadotropin-releasing hormone antagonist (GnRH-A) protocol in the patients with decreased ovarian reserve (DOR). Methods A retrospective analysis of clinical outcomes and costs was performed in 302 infertile patients with DOR afterin vitrofertilization-embryo transfer (IVF-ET) in our hospital from October 2014 to October 2016. According to different ages, patients were divided into <35 years old group (153 cases) and≥35 years old group (149 cases). And according to the different protocol, <35 years old group was divided into 3 groups, whichincluded 62 cycles of GnRH-A protocol (group A), 43 cycles of ultra-long protocol (group B), 48 cycles of minimal ovarian stimulation protocol (group C), and≥35 years old group was divided into 3 groups, which included 45 cycles of GnRH-A protocol (group D), 48 cycles of minimal ovarian stimulation protocol (group E), 56 cycles of mild stimulation protocol with GnRH-A (group F), clinical outcomes and the cost-effective ratio were compared between GnRH-A protocol and other protocols. Results In the patients 0.05). These economic indicators including the each mature eggs cost, the each good embryo cost and the each live birth cost were the lowest in group F (P<0.05). Conclusion The GnRH-A protocol was an ideal solution in less than 35 years patients with DOR; the mild stimulation protocol with GnRH-A was better than the other protocols in more than 35 years patients with DOR. Key words: Gonadotropin-releasing hormone antagonist (GnRH-A) protocol; Mild stimulation protocol with GnRH antagonist; Cost efficiency ratio; Decreased ovarian reserve (DOR)