GnRH agonist versus GnRH antagonist in endometrium
Ana María Muñoz Ledesma (ES), Marta Garcia-Yuste Gonzalez (ES), Mayte Navarro (ES), Mºcarmen Gonzalez Tejero (ES), Jose Schneider Fontan (ES)
[Muñoz Ledesma ] University hospital Río Hortega, [Garcia-Yuste Gonzalez] University hospital Río Hortega, [Navarro] University hospital Río Hortega, [Gonzalez Tejero] University hospital Río Hortega, [Schneider Fontan]
OBJECTIVES Multiple studies have described the incidence of endometrial polyps among infertile patients, but few studies describe the incidence of endometrial polyps during ovarian stimulation treatments. Although several studies compare agonist vs antagonist protocols in regards to pregnacy success rate and incidence of ovarian hyperstimulation syndrome (OHSS), the incidence of endometrial polyps in these protocols seems not to be addressed. We describe the incidence of endometrial polyps in patients with ovarian stimulation with gonadotropins for IVF / ICSI, who did not have evidence of endometrial pathology at the beginning of the cycle. Our study suggest that the rate of incedence may significantly differ when comparing agonist vs antagonist protocols. METHODS A full-year retrospective study of 170 cycles at our hospital. To determine the incidence of endometrial polyp diagnosed after ovarian stimulation in cycles of IVF / ICSI, with baseline ultrasounds at the beginning of the normal stimulation. All patients needed hysteroscopy at the time of puncture and subsequent histopathologic study confirmed the endometrial polyp. RESULTS The incidence of endometrial polyp was found to be 4.1 %. A significant difference was observed depending on the type of stimulation used. 71 % of cycles were antagonist, 28% agonist. 100 % of polyps were diagnosed in antagonists cycles. No cases were found in agonist cycles. CONCLUSION Despite its low incidence, the results of our study suggests that risk of endometrial polypoid proliferation is higher in antagonist treatments.