A retrospective, observational, single center study of gonadotropin-releasing hormone agonist protocols at the Reproductive Center of Farah Hospital in Jordan


  • Zaid Kilani General Director, Farah Hospital, Amman, Jordan
  • Mohammad Shaban Department of Gynecology and Assisted Reproduction, Farah Hospital, Amman, Jordan




Fertility, GnRH-agonists, Implantation, Infertility, In vitro fertilization


Background: Data on infertility and in vitro fertilization (IVF) are incomplete and uncertain in Jordan and worldwide because of difficulties in evaluating infertility in the general population. This study aimed at comparing the effectiveness of the gonadotropin-releasing hormone agonists (GnRH-a) long and short protocols as part of IVF or intracytoplasmic sperm injection.

Methods: This observational, retrospective, comparative, longitudinal study was conducted in a reproductive center in Jordan. It reviewed data charts from women who took GnRH-a for IVF, from 2010 to 2013. These were categorized in Group A (long-term GnRH-a: single 3.75 mg-monthly injection) or Group B (short-term GnRH-a: multiple daily 0.1 mg injections). The primary endpoint was the rate of ongoing clinical pregnancy (number of pregnancies/number of women) and live birth rate in fresh cycle/protocols.

Results: Out of 1,946 eligible women, 471 underwent the long-term treatment of GnRH-a administration and 1,523 the short-term treatment. The women’s mean age was 29.61±3.80 years old. Out of the 471 women in Group A, 216 (45.9%) women had ongoing clinical pregnancy, of whom 69 (31.9%) had live births. In the short-protocol group, 485 (31.8%) women had ongoing clinical pregnancy, of whom 133 (27.4%) had live births.

Conclusions: GnRH-a long protocol is more effective than the short protocol regardless of the agonist formulation used in subfertile women/men who underwent IVF/ intracytoplasmic sperm injection.


Zegers-Hochschild F, Adamson GD, Mansour R, Nygren K, Sullivan E, Vanderpoel S. On behlaf of ICMART and WHO. The International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) Revised Glossary on ART Terminology, 2009. Hum Reprod. 2009;24:2683-7.

World Health Organisation. Sexual and reproductive health. Infertility definitions and terminology. Available at: http://www.who.int/reproductivehealth/topics/infertility/definitions/en/. Accessed 13 June 2018.

Brzakowski M, Lourdel E, Cabry R, Oliérica MF, Claeys C, Devaux A, et al. Epidemiology of the infertile couple. J Gynecol Obstet Hum Reprod. 2009;38:F3-F7.

Gnoth C, Godehardt E, Frank-Herrmann P, Friol K, Tigges J, Freundl G. Definition and prevalence of subfertility and infertility. Hum Reprod. 2005;20: 1144-7.

World Health Organisation. Current practices and controversies in assisted reproduction, Report of a meeting on “Medical, ethical and social aspects of assisted reproduction, 2001. Available at: http://whqlibdoc.who.int/hq/2002/9241590300.pdf. Accessed 29 July 2013.

Le Goff S, Lédée N, Bader G. Obesity and reproduction: literature review. Gynecol Obstet Fertil. 2008;36:543-50.

Guivarc'h-Levêque A, Jaffré F, Homer L, Moy L, Priou G, Colleu D, et al. GnRH agonist triggering in IVF and luteal phase support in women at risk of ovarian hyperstimulation syndrome. Gynecol Obstet Fertil. 2013;41:511-4.

Barlow DH. GnRH agonists and in vitro fertilization. J Reprod Med. 1998;43:245-51.

Costello M, Misso M, Wong J, Hart R, Rombauts L, Melder A, et al. The treatment of infertility in polycystic ovarian syndrome: a brief update. Aust N Z J Obstet Gynaecol. 2012;52:400-3.

Asunción M, Calvo RM, San Millán JL, Sancho J, Avila S, Escobar- Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85:2434-8.

Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83:3078-82.

Youssef H, El Deeb W, Shawky O, Metawe M, Goda H. GnRH agonist long protocol versus short protocol in women 40 years or more undergoing ICSI: a multicenter study. Middle East Fertil Soc J. 2008;13:63-6.

Ou J, Xing W1, Li Y, Xu Y, Zhou C. Short versus long gonadotropin-releasing hormone analogue suppression protocols in IVF/ICSI cycles in patients of various age ranges. PLoS One 2015;10(7):e0133887.

Daya S. Gonadotropin releasing hormone agonist protocols for pituitary desensitization in in vitro fertilization and gamete intrafallopian transfer cycles. Cochrane Database Syst Rev. 2000;(2):CD001299.




How to Cite

Kilani, Z., & Shaban, M. (2019). A retrospective, observational, single center study of gonadotropin-releasing hormone agonist protocols at the Reproductive Center of Farah Hospital in Jordan. International Journal of Research in Medical Sciences, 7(8), 3103–3110. https://doi.org/10.18203/2320-6012.ijrms20193402



Original Research Articles