The cost-effectiveness analysis of the GnRH antagonist protocol and GnRH agonist short protocol for patients with poor ovarian response undergoing IVF–ET: A retrospective study.

Abstract Objective: To compare the clinical efficacy and cost-effectiveness of the gonadotropin-releasing hormone antagonist (GnRH-ant) regimen and GnRH agonist (GnRH-a) short regimen for patients with poor ovarian response (POR). Methods: A total of 951 cycles for patients with POR who underwent in vitro fertilization-embryo transfer (IVF – ET) in the Reproductive and Genetic Center of The People's Hospital of Guangxi Zhuang Autonomous Region from January 2016 to June 2022 were recruited for this retrospective analysis. There were 659 oocyte retrieval cycles in the GnRH-ant regimen group and 269 cycles in theGnRH-a short regimen group. There were 233 embryo transfercycles in the GnRH-ant regimen group and 100 cycles in theGnRH-a short regimen group. The general situations, treatment outcomes and costs of the two groups were compared. Results: There was no significant difference in the general situation, pregnancy outcome, total oocyte retrieval cost or total embryo transplantation cost between the two groups. However, the oocyte retrieval cost/oocyte retrievalcycle, high-quality embryo cost/oocyte retrieval cycle, and transferable embryo cost/oocyte retrieval cycle in the GnRH-ant regimen group were higher than those in the GnRH-a short regimen group, while the clinical pregnancy cost/embryo transfer cycle and ongoing pregnancy cost/embryo transfer cycle in the GnRH-ant regimen group were lower than those in the GnRH-a short regimen group. Conclusion: Both the GnRH-ant regimen and GnRH-a short regimen are effective ovulation induction regimens for POR patients, and there is no significant difference in clinical efficacy between the two groups. However, in terms of pregnancy outcome, the GnRH-ant regimen is more favorable and has more economic advantages.