Volume 19, Issue 10 (October 2021)                   IJRM 2021, 19(10): 863-872 | Back to browse issues page


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Zareii A, Davoodi S, Alborzi M, Eslami Moghadam M, Askary E. Co-administration GnRH agonists with vaginal progesterone compared to vaginal progesterone in luteal phase support of the frozen-thawed embryo transfer cycle: An RCT. IJRM 2021; 19 (10) :863-872
URL: http://ijrm.ir/article-1-1822-en.html
1- Infertility Division, Infertility Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
2- Infertility Division, Infertility Research Center, Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
3- Infertility Division, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
4- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
5- Department of Obstetrics and Gynecology, Laparoscopy Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. , elliaskary_md@yahoo.com
Abstract:   (1569 Views)
Background: Since progesterone alone does not seem to be enough for luteal phase support (LPS), especially in frozen embryo transfer (FET) cycles, so gonadotropin-releasing hormone agonist (GnRH-a) is suggested as an adjuvant therapy in combination with progesterone for LPS.
Objective: To evaluate the effects of the administration of GnRH-a with vaginal progesterone compared to vaginal progesterone alone in luteal phase support of the frozen-thawed embryo transfer cycles.
Materials and Methods: In this randomized controlled clinical trial, 240 infertile women who were candidate for FET were evaluated into two groups (n = 120/each). Group I received 400 mg vaginal progesterone twice a day from the time of transfer. Second group received vaginal progesterone and also 0.1 mg diphereline on days 0, 3, and 6 of FET for LPS. Finally, the clinical and ongoing pregnancy rates, and the implantation, and spontaneous abortion rates were compared in two groups.
Results: Results showed that there was no significant difference between the mean age of women and the duration of infertility (p = 0.78, p = 0.58, respectively). There were no significant differences between groups in the terms of implantation and spontaneous abortion rates (p = 0.19, p = 0.31, respectively). However, in terms of clinical and ongoing pregnancy rates, the significant differences were seen between groups (p = 0.008 and p = 0.005, respectively).
Conclusion: Co-administration of GnRH-a and vaginal progesterone in LPS may be superior to vaginal progesterone alone in women who underwent a frozen-selected embryo transfer cycle.
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Type of Study: Original Article | Subject: Fertility & Infertility

References
1. Mascarenhas MN, Flaxman SR, Boerma T, Vanderpoel Sh, Stevens GA. National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys. PLoS Med 2012; 9: e1001356. [DOI:10.1371/journal.pmed.1001356] [PMID] [PMCID]
2. Chandra A, Copen CE, Stephen EH. Infertility service use in the United States: Data from the national survey of family growth, 1982-2010. Natl Health Stat Report 2014; 73: 1-21.
3. Wang JG, Douglas NC, Dicken C, Nakhuda GS, Guarnaccia MM, Sauer MV. Cryopreservation of supernumerary high quality embryos predicts favorable outcomes for patients undergoing repeated cycles of in vitro fertilization. Fertil Steril 2008; 89: 368-374. [DOI:10.1016/j.fertnstert.2007.03.031] [PMID]
4. Stern JE, Lieberman ES, Macaluso M, Racowsky C. Is cryopreservation of embryos a legitimate surrogate marker of embryo quality in studies of assisted reproductive technology conducted using national databases? Fertil Steril 2012; 97: 890-893. [DOI:10.1016/j.fertnstert.2011.12.050] [PMID]
5. Bar Hava I, Yafee H, Omer Y, Humaidan P, Ganer Herman H. GnRHa for trigger and luteal phase support in natural cycle frozen embryo transfer: A proof of concept study. Reprod Biol 2020; 20: 282-287. [DOI:10.1016/j.repbio.2020.07.009] [PMID]
6. Wennerholm UB, Soderstrom-Anttila V, Bergh C, Aittomaki K, Hazekamp J, Nygren KG, et al. Children born after cryopreservation of embryos or oocytes: A systematic review of outcome data. Hum Reprod 2009; 24: 2158-2172. [DOI:10.1093/humrep/dep125] [PMID]
7. Maheshwari A, Pandey Sh, Amalraj Raja E, Shetty A, Hamilton M, Bhattacharya S. Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer? Hum Reprod Update 2018; 24: 35-58 [DOI:10.1093/humupd/dmx031] [PMID]
8. Merce LT, Barco MJ, Bau S, Troyano J. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome? Fertil Steril 2008; 89: 111-117. [DOI:10.1016/j.fertnstert.2007.02.029] [PMID]
9. Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril 2007; 87: 53-59. [DOI:10.1016/j.fertnstert.2006.05.064] [PMID]
10. Eftekhar M, Rahsepar M, Rahmani E. Effect of progesterone supplementation on natural frozen-thawed embryo transfer cycles: a randomized controlled trial. Int J Fertil Steril 2013; 7: 13-20.
11. Bjuresten K, Landgren BM, Hovatta O, Stavreus-Evers A. Luteal phase progesterone increases live birth rate after frozen embryo transfer. Fertil Steril 2011; 95: 534-537. [DOI:10.1016/j.fertnstert.2010.05.019] [PMID]
12. Kim CH, Lee YJ, Lee KH, Kwon SK, Kim SH, Chae HD, et al. The effect of luteal phase progesterone supplementation on natural frozen-thawed embryo transfer cycles. Obstet Gynecol Sci 2014; 57: 291-296. [DOI:10.5468/ogs.2014.57.4.291] [PMID] [PMCID]
13. Alsbjerg B, Polyzos NP, Elbaek HO, Povlsen BB, Andersen CY, Humaidan P. Increasing vaginal progesterone gel supplementation after frozen-thawed embryo transfer significantly increases the delivery rate. Reprod Biomed Online 2013; 26: 133-137. [DOI:10.1016/j.rbmo.2012.10.012] [PMID]
14. De Ziegler D, Pirtea P, Yding Andersen C, Marc Ayoubi J. Role of gonadotropin-releasing hormone agonists, human chorionic gonadotropin (hCG), progesterone, and estrogen in luteal phase support after hCG triggering, and when in pregnancy hormonal support can be stopped. Fertil Steril 2018; 109: 749-755. [DOI:10.1016/j.fertnstert.2018.03.006] [PMID]
15. Song M, Liu Ch, Hu R, Wang F, Huo Zh. Administration effects of single-dose GnRH agonist for luteal support in females undertaking IVF/ICSI cycles: A meta-analysis of randomized controlled trials. Exp Ther Med 2020; 19: 786-796. [DOI:10.3892/etm.2019.8251]
16. Aunapuu M, Kibur P, Järveots T, Arend A. Changes in morphology and presence of pinopodes in endometrial cells during the luteal phase in women with infertility problems: A pilot study. Medicina 2018; 54: 69. [DOI:10.3390/medicina54050069] [PMID] [PMCID]
17. Lan VTN, Tuan PH, Canh LT, Tuong HM, Howles CM. Progesterone supplementation during cryopreserved embryo transfer cycles: efficacy and convenience of two vaginal formulations. Reprod Biomed Online 2008; 17: 318-323. [DOI:10.1016/S1472-6483(10)60214-3]
18. Van der Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev 2011; 10: Cd009154. [DOI:10.1002/14651858.CD009154.pub2]
19. 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] [PMID]
20. 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] [PMID]
21. Kyrou D, Kolibianakis EM, Fatemi HM, Tarlatzi TB, Devroey P, Tarlatzis BC. 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] [PMID]
22. Yu LP, Liu N, Liu Y. [Effect of luteal-phase gonad-otropin-releasing hormone agonist administration on pregnancy outcome in IVF/ICSI cycles: A systematic review and Meta-analysis.] Zhonghua Fu Chan Ke Za Zhi 2016; 51: 850-858. (In Chinese)
23. Oliveira JBA, Baruffi R, Petersen CG, Mauri AL, Cavagna M, FrancoJr JG. Administration of single-dose GnRH agonist in the luteal phase in ICSI cycles: A meta-analysis. Reprod Biol Endocrinol 2010; 8: 107-117. [DOI:10.1186/1477-7827-8-107] [PMID] [PMCID]
24. Khan N, Richter KS, Newsome TL, Blake EJ, Yankov VI. Matched-samples comparison of intramuscular versus vaginal progesterone for luteal phase support after in vitro fertilization and embryo transfer. Fertil Steril 2009; 91: 2445-2450. [DOI:10.1016/j.fertnstert.2008.03.072] [PMID]
25. Miralpeix E, Gonzalez-Comadran M, Sola I, Manau D, Carreras R, Checa MA. Efficacy of luteal phase support with vaginal progesterone in intrauterine insemination: A systematic review and meta-analysis. J Assist Reprod Genet 2014; 31: 89-100. [DOI:10.1007/s10815-013-0127-6] [PMID] [PMCID]
26. Erdem A, Erdem M, Atmaca S, Guler I. Impact of luteal phase support on pregnancy rates in intrauterine insemination cycles: A prospective randomized study. Fertil Steril 2009; 91: 2508-2513. [DOI:10.1016/j.fertnstert.2008.04.029] [PMID]
27. Humaidan P, Bredkjaer HE, Bungum L, Bungum M, Grøndahl ML, Westergaard L, et al. GnRH agonist (buserelin) or hCG for ovulation induction in GnRH antagonist IVF/ICSI cycles: A prospective randomized study. Hum Reprod 2005; 20: 1213-1220. https://doi.org/10.1093/humrep/deh765 [DOI:10.1093/humrep/dei191] [PMID]
28. Practice Committee of the American Society for Reproductive Medicine. Guidance on the limits to the number of embryos to transfer: A committee opinion. Fertil Steril 2017; 107: 901-903.
29. 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] [PMID]
30. Dehghani Firouzabadi R, Ayazi Rozbahani M, Tabibnejad N. Beneficial effect of luteal-phase gonado-tropin-releasing hormone agonist administration on implantation rate after intracytoplasmic sperm injection. Taiwan J Obstet Gynecol 2009; 48: 245-248. [DOI:10.1016/S1028-4559(09)60297-7]
31. Papanikolaou EG, Platteau P, Albano C, Kolibianakis E, Devroey P. Achievement of pregnancy threetimes in the same patient during luteal GnRH agonist administration. Reprod Biomed Online 2005; 10: 347-349. [DOI:10.1016/S1472-6483(10)61794-4]
32. Platteau P, Gabbe M, Talbot M, Healy D. Two consecutive pregnancies during inadvertent gonadotropin-releasing hormone agonist desensitization. Fertil Steril 2000; 73: 1244-1246. [DOI:10.1016/S0015-0282(00)00536-7]
33. Tan HH, Yeong ChT, Loh KESh. Perinataloutcome of pregnancies after inadvertentexposure to gonadotrophin-releasing hor-mone analogue. Aust N Z J Obstet Gynaecol 2006; 46: 336-340. [DOI:10.1111/j.1479-828X.2006.00602.x] [PMID]
34. van der Linden M, Buckingham K, Farquhar C, Kremer JAM, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev 2015; 2015: CD009154. [DOI:10.1002/14651858.CD009154.pub3] [PMID] [PMCID]
35. 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] [PMID]
36. Zafardoust S, Jeddi-Tehrani M, Akhondi MM, Sadeghi MR, Kamali K, Mokhtar S, et al. Effect of administration of single dose GnRH agonist in luteal phase on outcome of ICSI-ET cycles in women with previous history of IVF/ICSI failure: A randomized controlled trial. J Reprod Infertil 2015; 16: 96-101.
37. 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 intracyto-plasmic 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] [PMID]
38. Bar-Hava I, Mizrachi Y, Karfunkel-Doron D, Omer Y, Sheena L, Carmon N, et al. Intranasal gonadotropin-releasing hormone agonist (GnRHa) for luteal-phase support following GnRHa triggering, a novel approach to avoid ovarian hyperstimulation syndrome in high responders. Fertil Steril 2016; 106: 330-333. [DOI:10.1016/j.fertnstert.2016.04.004] [PMID]
39. Mendoza-Tesarik R, Mendoza N, López CC, Tesarik J. GnRH agonist treatment of luteal phase deficiency in HCG-triggered IVF cycles: A matched case-control study. Reprod Biomed Online 2019; 39: 225-230. [DOI:10.1016/j.rbmo.2019.03.215] [PMID]
40. Tesarik J, Mendoza-Tesarik R, Mendoza N. Gonadotropin-releasing hormone agonist for luteal phase support: the origin of the concept, current experience, mechanism of action and future perspectives. Fertil Steril 2016; 106: 268-269. [DOI:10.1016/j.fertnstert.2016.04.034] [PMID]
41. 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 agonist protocol: A randomized, controlled double blind study. Hum Reprod 2008; 23: 668-673. [DOI:10.1093/humrep/dem421] [PMID]
42. Inamdar DB, Majumdar A. Evaluation of the impact of gonadotropin-releasing hormone agonist as an adjuvant in luteal-phase support on IVF outcome. J Hum Reprod Sci 2012; 5: 279-284. [DOI:10.4103/0974-1208.106341] [PMID] [PMCID]
43. Aboulghar MA, Marie H, Amin YM, Aboulghar MM, Nasr A, Serour GI, et al. 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] [PMID]
44. Davar R, Farid Mojtahedi M, Miraj S. Effects of single dose GnRH agonist as luteal support on pregnancy outcome in frozen-thawed embryo transfer cycles: An RCT. Iran J Reprod BioMed 2015; 13: 483-488.
45. Balayla J, Sheehy O, Fraser WD, Séguin JR, Trasler J, Monnier P, et al. Neurodevelopmental outcomes after assistedreproductive technologies. Obstet Gynecol 2017; 129: 265-272. [DOI:10.1097/AOG.0000000000001837] [PMID] [PMCID]
46. Zhan QT, Pan PP, Xu XR, Lou HY, Lou YY, Jin F. An over-view of studies on psychological well-beingin children born following assisted reproduc-tive technologies. J Zhejiang Univ Sci B 2013; 14: 947-960. [DOI:10.1631/jzus.B1300101] [PMID] [PMCID]
47. Li Sh, Li Y. Administration of a GnRH agonist during the luteal phase frozen-thawed embryo transfer cycles: A meta-analysis. Gynecol Endocrinol 2018; 34: 920-924. [DOI:10.1080/09513590.2018.1480714] [PMID]
48. Zarei A, Sohail P, Parsanezhad ME, Alborzi S, Samsami A, Azizi M. Comparison of four protocols for luteal phase support in frozen-thawed embryo transfer cycles:a randomized clinical trial. Arch Gynecol Obstet 2017; 295: 239-246. [DOI:10.1007/s00404-016-4217-4] [PMID]
49. Humaidan P, Kol S, Papanikolaou EG. GnRH agonist for triggering offinal oocytematuration: Time for a change of practice? Hum Reprod Update 2011; 17: 510-524. [DOI:10.1093/humupd/dmr008] [PMID]
50. Shapiro BS, Daneshmand ST, Restrepo H, Garner FC. Serum HCG measured in theperi-implantation period predicts IVF cycle outcomes. Reprod Biomed Online 2012; 25: 248-253. [DOI:10.1016/j.rbmo.2012.05.015] [PMID]

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