الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The use of GnRH agonist during COH before ART has become almost a routine. The most commonly used protocol is the long luteal agonist protocol; where the agonist is usually started during the mid-luteal phase (day 21) of a 28-day menstrual cycle. Until now, we don’t know whether variation of day of start of GnRH agonist during the luteal phase in long protocols affects dose or duration of drugs during suppression or stimulation phase of COH cycle and also we don’t know if this variation affects response to treatment quantitatively or qualitatively.
The aim of this study was to evaluate the impact of day of initiation of GnRH agonist during the luteal phase in long agonist protocol on ICSI cycle endocrinology and outcome.
The agonist used in this study is Triptorelin (Decapeptyl), which is given as 0.1 mg dosage, subcutaneously once daily till complete pituitary desensitization occurs. This is evidenced by occurrence menses and when serum estradiol level is less than 50 pg/ ml.
This study included 90 infertile women, divided equally into 3 groups: Group A; where the GnRH agonist was started on day 19 of the menstrual cycle, group B; the agonist was started on day 21 of the cycle and group C; the agonist was started on day 23 of the cycle.
The results of the study have showed that there was no statistical difference between the 3 groups with respect to age, type & cause of infertility and level of serum FSH.
When GnRH agonist results were compared, there was a statistically significant difference between groups A & B and between groups A & C regarding the total dose of Decapeptyl used. However, the added cost of this higher GnRH dose in the first group in relation to the overall cycle cost is insignificant.
As regards the hMG results, there was no statistical significant difference between the 3 groups concerning the total number of hMG ampoules used and the number of stimulation days.
Finally, there was no statistically significant difference between the 3 groups regarding the final serum estradiol level, pregnancy rate and ongoing pregnancy rate. However, the highest pregnancy rate was noticed in the second group (56.7 %) compared with only 36.7 % in the other two groups.