Volume 13, Issue 8 (9-2015)
IJRM 2015, 13(8): 483-488 |
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1- Reasearch and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Reasearch and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , m_fmojtahedi@yahoo.com
2- Reasearch and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , m_fmojtahedi@yahoo.com
Abstract: (2916 Views)
Background: There is no doubt that luteal phase support is essential to enhance the reproductive outcome in IVF cycles. In addition to progesterone and human chorionic gonadotropin, several studies have described GnRH agonists as luteal phase support to improve implantation rate, pregnancy rate and live birth rate, whereas other studies showed dissimilar conclusions. All of these studies have been done in fresh IVF cycles.
Objective: To determine whether an additional GnRH agonist administered at the time of implantation for luteal phase support in frozen-thawed embryo transfer (FET) improves the embryo developmental potential.
Materials and Methods: This is a prospective controlled trial study in 200 FET cycles, patients were randomized on the day of embryo transfer into group 1 (n=100) to whom a single dose of GnRH agonist (0.1 mg triptorelin) was administered three days after transfer and group 2 (n=100), who did not receive agonist. Both groups received daily vaginal progesterone suppositories plus estradiol valerate 6 mg daily. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were implantation rate, chemical, ongoing pregnancy rate and abortion rate.
Results: A total of 200 FET cycles were analyzed. Demographic data and embryo quality were comparable between two groups. No statistically significant difference in clinical and ongoing pregnancy rates was observed between the two groups (26% versus 21%, p=0.40 and 21% versus 17%, p=0.37, respectively).
Conclusion: Administration of a subcutaneous GnRH agonist at the time of implantation does not increase clinical or ongoing pregnancy.
Objective: To determine whether an additional GnRH agonist administered at the time of implantation for luteal phase support in frozen-thawed embryo transfer (FET) improves the embryo developmental potential.
Materials and Methods: This is a prospective controlled trial study in 200 FET cycles, patients were randomized on the day of embryo transfer into group 1 (n=100) to whom a single dose of GnRH agonist (0.1 mg triptorelin) was administered three days after transfer and group 2 (n=100), who did not receive agonist. Both groups received daily vaginal progesterone suppositories plus estradiol valerate 6 mg daily. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were implantation rate, chemical, ongoing pregnancy rate and abortion rate.
Results: A total of 200 FET cycles were analyzed. Demographic data and embryo quality were comparable between two groups. No statistically significant difference in clinical and ongoing pregnancy rates was observed between the two groups (26% versus 21%, p=0.40 and 21% versus 17%, p=0.37, respectively).
Conclusion: Administration of a subcutaneous GnRH agonist at the time of implantation does not increase clinical or ongoing pregnancy.
Type of Study: Original Article |
References
1. Tavaniotou A, Albano C, Smitz J, Devroey P. Comparison of LH concentrations in the early and mid-luteal phase in IVF cycles after treatment with HMG alone or in association with the GnRH antagonist Cetrorelix. Hum Reprod 2001; 16: 663-667. [DOI:10.1093/humrep/16.4.663]
2. Pritts E, Atwood A. Luteal phase support in infertility treatment: a meta-analysis of the randomized trials. Hum Reprod 2002; 17: 2287-2299. [DOI:10.1093/humrep/17.9.2287]
3. Beckers N, Macklon GNS, Eijkemans MJ, Ludwig M, Felberbaum RE, Diedrich K, et al. Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment. J Clin Endocrinol Metabol 2003; 88: 4186-4192. [DOI:10.1210/jc.2002-021953]
4. Daya S, Gunby J. Luteal phase support in assisted reproduction cycles. Cochrane Database Syst Rev 2004; CD004830. [DOI:10.1002/14651858.CD004830]
5. Tesarik J, Hazout A, Mendoza C. Enhancement of embryo developmental potential by a single administration of GnRH agonist at the time of implantation. Hum Reprod 2004; 19: 1176-1180. [DOI:10.1093/humrep/deh235]
6. Pirard C, Donnez J, Loumaye E. GnRH agonist as novel luteal support: results of a randomized, parallel group, feasibility study using intranasal administration of buserelin. Hum Reprod 2005; 20: 1798-1804. [DOI:10.1093/humrep/deh830]
7. Pirard C, Donnez J, Loumaye E. GnRH agonist as luteal phase support in assisted reproduction technique cycles: results of a pilot study. Hum Reprod 2006; 21: 1894-1900. [DOI:10.1093/humrep/del072]
8. Tesarik J, Hazout A, Mendoza-Tesarik R, Mendoza N, Mendoza C. Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist-and antagonist-treated ovarian stimulation cycles. Hum Reprod 2006; 21: 2572-2579. [DOI:10.1093/humrep/del173]
9. Kyrou D, Kolibianakis E, Fatemi H, Tarlatzi T, Devroey P, Tarlatzis B. Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: a systematic review and meta-analysis. Hum Reprod update 2011; 17: 734-740. [DOI:10.1093/humupd/dmr029]
10. Ata B, Yakin K, Balaban B, Urman B. GnRH agonist protocol administration in the luteal phase in ICSI–ET cycles stimulated with the long GnRH agonistprotocol: a randomized, controlled double blind study. Hum Reprod 2008; 23: 668-673. [DOI:10.1093/humrep/dem421]
11. Inamdar DB, Majumdar A. Evaluation of the impact of gonadotropin-releasing hormone agonist as an adjuvant in luteal-phase support on IVF outcome. J of Hum Reprod Sci 2012; 5: 279-284. [DOI:10.4103/0974-1208.106341]
12. Geber S, Sampaio M. Effect of duration of the GnRH agonists in the luteal phase in the outcome of assisted reproduction cycles. Gynecol Endocrinol 2013; 29: 608-610. [DOI:10.3109/09513590.2013.788635]
13. Aboulghar MA, Marie H, Amin YM, Aboulghar MM, Nasr A, Serour GI, et al. Mansour . GnRH agonist plus vaginal progesterone for luteal phase support in ICSI cycles: a randomized study. Reprod Biomed Online 2015; 30: 52-56. [DOI:10.1016/j.rbmo.2014.09.017]
14. Raga F, Casa- EM, Kruessel JS, Wen Y, Huang HY, Nezhat C, et al. Quantitative gonadotropin-releasing hormone gene expression and immunohistochemical localization in human endometrium throughout the menstrual cycle. Biol Reprod 1998; 59: 661-669. [DOI:10.1095/biolreprod59.3.661]
15. Takeuchi S, Futamura N, Minoura H, Toyoda N. Possible direct effect of gonadotropin releasing hormone on human endometrium and decidua. Life Sci 1998; 62: 1187-1194. [DOI:10.1016/S0024-3205(98)00045-9]
16. Fauser BC, Devroey P. Reproductive biology and IVF: ovarian stimulation and luteal phase consequences. Trends Endocrinol Metab 2003; 14: 236-242. [DOI:10.1016/S1043-2760(03)00075-4]
17. Kung HF, Chen MJ, Guua HF, Chen YF, Yi YC, Yen-Ping Ho J, et al. Luteal phase support with decapeptyl improves pregnancy outcomes in intracytoplasmic sperm injection with higher basal follicle-stimulating hormone or lower mature oocytes. J Chin Med Assoc 2014; 77: 524-530. [DOI:10.1016/j.jcma.2014.07.001]
18. Yildiz GA, Sukur YE, Ates C, Aytac R. The addition of gonadotrophin releasing hormone agonist to routine luteal phase support in intracytoplasmic sperm injection and embryo transfer cycles: a randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2014; 182: 66-70. [DOI:10.1016/j.ejogrb.2014.08.026]
19. Isik AZ, Caglar GS, Sozen E, Akarsu C, Tuncay G, Ozbıcer T et al. Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study. Reprod biomed online 2009; 19: 472-477. [DOI:10.1016/j.rbmo.2009.04.001]
20. Dehghani Firouzabadi R, Ayazi Rozbahani M, Tabibnejad. Beneficial Effect of Luteal-phase Gonadotropin-releasing Hormone Agonist Administration on Implantation Rate Afterintracytoplasmic Sperm Injection. Taiwan J Obstet Gynecol 2009; 48: 245-248. [DOI:10.1016/S1028-4559(09)60297-7]
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