Can we skip weekends in GnRH antagonist cycles without compromising the final outcome?
Gonadotropin-releasing hormone (GnRH) antagonists were introduced into clinical practice more than a decade ago. However, although they offer a number of advantages compared with GnRH agonists, their introduction in daily practice has been slower than initially could be expected. A major drawback for their consolidation has been the limitation for programming cycles, as when the GnRH antagonist protocol gonadotropin administration is started on day 2 or 3 of menses, which is clearly an unpredictable event. Meanwhile, most IVF units are used to the control that the GnRH agonist long protocol offers for scheduling the initiation of stimulation in order to maximize the probability of having oocyte collection on a weekday. This is of paramount importance in both small units to avoid pick-ups on weekends, and in large units to distribute the workload to their convenience during the week. This should not be considered a trivial issue, as working a regular 5-day week may require fewer staff, is less costly and reduces pressure on staff members by allowing regular weekends off . Moreover, a planned distribution of the workload in the IVF lab avoids excessive openings of incubators and their negative impact on embryo development, and helps to better organize shifts without extra effort or unplanned work that may result in loss of concentration and reduced efficiency of embryologists and technicians .