Volume 10, Issue 4 (8-2012)                   IJRM 2012, 10(4): 297-302 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Eftekhar M, Dehghani Firouzabadi R, Karimi H, Rahmani E. Outcome of cryopreserved-thawed embryo transfer in the GnRH agonist versus antagonist protocol. IJRM 2012; 10 (4) :297-302
URL: http://ijrm.ir/article-1-300-en.html
Outcome of cryopreserved-thawed embryo transfer in the GnRH agonist versus antagonist protocol
Maryam Eftekhar1 , Razieh Dehghani Firouzabadi * 2, Hesamoddin Karimi1 , Elham Rahmani1
1- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , dr_firouzabadi@ssu.ac.ir
Abstract:   (3557 Views)
Background: GnRH agonist and antagonist were developed to control the premature release of LH surge. There is some difference between two protocols.
Objective: We compared the outcome of frozen-thawed embryo transfer in infertile women who used GnRH agonist or antagonist protocol for previous COH cycle and evaluation of any adverse effect of GnRH antagonist on oocyte and embryo.
Materials and Methods: The study group included all infertile women who referred to Yazd Research and Clinical Center for Infertility. Overall 20-35 years old women who were candidate for frozen-thawed embryo transfer with regard to inclusion and exclusion criteria were participated in the study. The patients based on previous control ovarian stimulation (COH) protocol divided in to two groups: GnRH agonist long protocol (n=165) and GnRH antagonist multiple dose protocol (n=165). Frozen-thawed embryos were transferred after endometrial preparation in both groups. Main outcome measures were: implantation, chemical and clinical pregnancy rate.
Results: The implantation and clinical pregnancy rate following cryopreserved embryo transfer in GnRH agonist group and antagonist group were 16.3% vs. 15.7% (p=0.806) and 38.1% (63/165) vs. 36.9% (61/165) (p=0.915) and chemical pregnancy rate was 44.8% (74/165) vs. 43.6% (72/165) (p=0.915) respectively.
Conclusion: There was no statistically difference between two groups in terms of implantation and pregnancy rate. Although pregnancy rate in fresh embryo transfer in antagonist cycles was lower than agonist groups, Therefore decrease in these parameters might be due to detrimental effect of GnRH antagonist on the endometrium, not embryo or oocyte.
Keywords: GnRH agonist, GnRH antagonist, Cryopreserved, Embryo transfer, Pregnancy outcome
Full-Text [PDF 399 kb]   (697 Downloads) |   |   Full-Text (HTML)  (407 Views)  
Type of Study: Original Article |
References
1. Sirayapiwat P, Suwajanakorn S, Triratanachat S, Niruthisard S. The effects of GnRH antagonist on the endometrium of normally menstruating women. J Assist Reprod Genet 2007; 24: 579-586. [DOI:10.1007/s10815-007-9184-z]
2. Coccia ME, Comparetto C, Bracco GL, Scarselli G. GnRH antagonists. Eur J Obstet Gynecol Reprod Biol 2004; 115 (supple.): 44-56. [DOI:10.1016/j.ejogrb.2004.01.033]
3. Seelig AS, Al-Hasani S, Katalinic A, Schöpper B, Sturm R, Diedrich K, et al. Comparison of cryopreservation outcome with gonadotropin-releasing hormone agonists or antagonists in the collecting cycle. Fertil Steril 2002; 77: 472-475. [DOI:10.1016/S0015-0282(01)03008-4]
4. Nikolettos N, Al-Hasani S, Felberbaum R, Demirel LC, Riethmüller-Winzen H, Reissmann T, et al. Comparison of cryopreservation outcome with human pronuclear stage oocytes obtained by the GnRH antagonist, cetrorelix, and GnRH agonists. Eur J Obstet Gynecol 2000; 93: 91-95. [DOI:10.1016/S0301-2115(99)00294-8]
5. Al-Inany H, Aboulghar M. GnRH antagonist in assisted reproduction: a Cochrane review. Hum Reprod 2002; 17: 874-875. [DOI:10.1093/humrep/17.4.874]
6. Al-Inany H, Abou-Setta A, Aboulghar M. Gonadotrophin-releasing hormone antagonists for assisted conception: a Cochrane review. Reprod Biomed Online 2007; 14: 640-649. [DOI:10.1016/S1472-6483(10)61059-0]
7. Kol S. Embryo implantation and GnRH antagonists. Hum Reprod 2000; 15: 1881-1882. [DOI:10.1093/humrep/15.9.1881]
8. Bahçeci M, Ulug U, Erden HF, Tosun S, Ciray N. Frozen-thawed cleavage-stage embryo transfer cycles after previous GnRH agonist or antagonist stimulation. Reprod Biomed Online 2009; 18: 67-72. [DOI:10.1016/S1472-6483(10)60426-9]
9. Kakar SS, Musgrove LC, Devor DC, Sellers JC, Neill JD. Cloning, sequencing, and expression of human gonadotropin releasing hormone (GnRH) receptor. Biochem Biophys Res Commun 1992; 189: 289-295. [DOI:10.1016/0006-291X(92)91556-6]
10. Chegini N, Rong H, Dou Q, Kipersztok S, Williams RS. Gonadotropin-releasing hormone (GnRH) and GnRH receptor gene expression in human myometrium and leiomyomata and the direct action of GnRH analogs on myometrial smooth muscle cells and interaction with ovarian steroids in vitro. J Clin Endocrinol Metab 1996; 81: 3215-3221.
11. Ortmann O, Diedrich K. Pituitary and extrapituitary actions of gonadotrophin-releasing hormone and its analogues. Hum Reprod 1999; 14: 194-206. [DOI:10.1093/humrep/14.suppl_1.194]
12. Casa- EM, Raga F, Polan ML. GnRH mRNA and protein expression in human preimplantation embryos. Mol Hum Reprod 1999; 5: 234-239. [DOI:10.1093/molehr/5.3.234]
13. Bahçeci M, Ulug U, Erden HF, Tosun S, çiray N. Frozen–thawed cleavage-stage embryo transfer cycles after previous GnRH agonist or antagonist stimulation. Reprod Biomed Online 2009; 18: 67-72. [DOI:10.1016/S1472-6483(10)60426-9]
14. Steer CV, Mills CL, Tan SL, Campbell S, Edwards RG. The cumulative embryo score: a predictive embryo scoring technique to select the optimal number of embryos to transfer in an in-vitro fertilization and embryo transfer programme. Hum Reprod 1992; 7: 117-119. [DOI:10.1093/oxfordjournals.humrep.a137542]
15. Khalaf M, Mittre H, Levallet J, Hanoux V, Denoual C, Herlicoviez M, et al. GnRH agonist and GnRH antagonist protocols in ovarian stimulation: differential regulation pathway of aromatase expression in human granulosa cells. Reprod Biomed Online 2010; 21: 56-65. [DOI:10.1016/j.rbmo.2010.03.017]
16. Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, et al. GnRH antagonists are safer than agonists: an update of a Cochrane review. Hum Reprod Update 2011; 17: 435. [DOI:10.1093/humupd/dmr004]
17. Medved R, Virant-Klun I, Meden-Vrtovec H, Tomaževi T. Outcome of frozen-thawed blastocysts derived from gonadotropin releasing hormone agonist or antagonist cycles. J Assist Reprod Genet 2006; 23: 275-279. [DOI:10.1007/s10815-006-9051-3]
18. Hershkovitz E, Marbach M, Bosin E, Levy J, Roberts CT Jr, LeRoith D, et al. Luteinizing hormone-releasing hormone antagonists interfere with autocrine and paracrine growth stimulation of MCF-7 mammary cancer cells by insulin-like growth factors. J Clin Endocrinol Metab 1993; 77: 963-968.
19. Hershkovitz E, Marbach M, Bosin E, Levy J, Roberts CT Jr, LeRoith D. Regulation of endometrial cancer cell growth by insulin-like growth factors and the luteinizing hormone-releasing hormone antagonist SB-75. Regul Pept 1993; 48: 91-98. [DOI:10.1016/0167-0115(93)90338-9]
20. Nikolettos N, Asimakopoulos B, Simopoulou M, Al-Hasani S, Diedrich K. Gonadotropin releasing hormone antagonists and cryopreservation outcome: a review. Arch Gynecol Obstet 2004; 270: 69-73. [DOI:10.1007/s00404-003-0597-3]
21. Weiss J, Krautmacher B, Polack S, Diedrich K, Ortmann O. Actions of GnRH antagonists on IGF-II, IGF-binding protein-2 and pregnancy-associated plasma protein-A in human granulosa-lutein cells. Eur J Endocrinol 2003; 149: 31-37. [DOI:10.1530/eje.0.1490031]
22. Asimakopoulos B, Schöpper B, Dawson A, Caglar GS, Vakalopoulos I, Al-Hasani S, et al. IGF-I and epidermal growth factor levels in follicular fluid of women undergoing controlled ovarian hyperstimulation using the multidose GnRH-antagonist protocol or the long GnRH-agonist protocol. J Endocrinol Invest 2006; 29: RC5-8. [DOI:10.1007/BF03344118]
23. Luo X, Ding L, Chegini N. Gonadotropin-releasing hormone and TGF-β activate MAP kinase and differentially regulate fibronectin expression in endometrial epithelial and stromal cells. Am J Physiol Endocrinol Metab 2004; 287: 991-1001. [DOI:10.1152/ajpendo.00200.2004]
24. Chou CS, Tai CJ, MacCalman CD, Leung PCK. Dose-Dependent Effects of Gonadotropin Releasing Hormone on Matrix Metalloproteinase (MMP)-2, and MMP-9 and Tissue Specific Inhibitor of Metalloproteinases-1 Messenger Ribonucleic Acid Levels in Human Decidual Stromal Cells in Vitro. J Clin Endocrinol Metab 2003; 88: 680-688. [DOI:10.1210/jc.2002-021277]
25. Kol S. Embryo implantation and GnRH antagonists. Hum Reprod 2000; 15: 1881-1882. [DOI:10.1093/humrep/15.9.1881]
26. Olivennes F, Belaisch-Allart J, Emperaire JC, Dechaud H, Alvarez S, Moreau L, et al. Prospective, randomized, controlled study of in vitro fertilization-embryo transfer with a single dose of a luteinizing hormone-releasing hormone (LH-RH) antagonist (cetrorelix) or a depot formula of an LH-RH agonist (triptorelin). Fertil Steril 2000; 73: 314-320. [DOI:10.1016/S0015-0282(99)00524-5]
27. Rackow BW, Kliman HJ, Taylor HS. GnRH antagonists may affect endometrial receptivity. Fertil Steril 2008; 89: 1234-1239. [DOI:10.1016/j.fertnstert.2007.04.060]
28. Prapas N, Prapas Y, Panagiotidis Y, Prapa S, Vanderzwalmen P, Schoysman R, et al. GnRH agonist versus GnRH antagonist in oocyte donation 1. Sirayapiwat P, Suwajanakorn S, Triratanachat S, Niruthisard S. The effects of GnRH antagonist on the endometrium of normally menstruating women. J Assist Reprod Genet 2007; 24: 579-586. [DOI:10.1007/s10815-007-9184-z]
29. Lee JR, Choi YS, Jee BC, Ku SY, Suh CS, Kim KC, et al. Cryopreserved blastocyst transfer: impact of gonadotropin-releasing hormone agonist versus antagonist in the previous oocyte retrieval cycles. Fertil Steril 2007; 88: 1344-1349. [DOI:10.1016/j.fertnstert.2007.01.013]
30. Eldar-Geva T, Zylber-Haran E, Babayof R, Halevy-Shalem T, Ben-Chetrit A, Tsafrir A, et al. Similar outcome for cryopreserved embryo transfer following GnRH-antagonist/GnRH-agonist, GnRH-antagonist/ HCG or long protocol ovarian stimulation. Reprod Biomed Online 2007; 14: 148-154. [DOI:10.1016/S1472-6483(10)60781-X]
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb