Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles

Tesařík, Jan; Hazout, A.; Mendoza-Tesarik, Raquel; Mendoza, Nicolás; Mendoza, Carmen

doi:10.1093/humrep/del173

Cited by 135 publications

(164 citation statements)

References 27 publications

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“…A natural cycle was chosen based on the previous study demonstrating higher ongoing pregnancy rate following the transfer of frozen-thawed embryos in natural cycles with spontaneous LH rise compared with natural cycles controlled by hCG for final oocyte maturation [12]; the administration of hCG injection on day of transfer was chosen based on the ability of hCG to further improve the function of the corpus luteum [13]; and the administration of GnRH-agonist relied on the previous observed higher pregnancy rate in patients who received a mid-luteal injection of a GnRH-agonist [14,15]. These latter effects were explained by a putative direct or indirect effect of the GnRH direct effect on the endometrium and/or corpus luteum.…”

Section: Discussionmentioning

confidence: 99%

Natural cycle frozen-thawed embryo transfer—can we improve cycle outcome?

Orvieto

Feldman

Lantsberg

et al. 2016

J Assist Reprod Genet

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Purpose Several replacement protocols for frozen-thawed ET (FET) exist, with no advantage of one protocol over the others. In the present study, we aim to evaluate the outcome of natural cycle FET with modified luteal support. Methods All consecutive patients undergoing natural or artificial hormone replacement (AHR) day-2/3 FET cycles between May 2012 and June 2015 in our IVF unit were evaluated. While AHR FET cycles were consistent, those undergoing natural cycle FET received progesterone luteal support, and from June 2014, patients received two additional injections, one of recombinant hCG and the other of GnRH-agonist, on day of transfer and 4 days later, respectively (modified luteal support). Results Patients' clinical characteristics and laboratory/ embryological variables were comparable between those undergoing natural vs. AHR cycles, during the earlier as compared to the later period. Moreover, while implantation, clinical, and ongoing pregnancy rates were significantly higher during the later period in patients undergoing the natural cycle FET with the modified luteal support (31, 51, and 46 %, respectively), as compared to natural (17, 26, and 20 %, respectively), or AHR FET in the late study period (15, 22, and 17 %, respectively), the natural cycle FET without the additional two injections yielded the same results, as the AHR cycles.Conclusions We therefore suggest that in ovulatory patients undergoing FET, natural cycle FET with the modified luteal support should be the preparation protocol of choice. Further large prospective studies are needed to elucidate the aforementioned recommendation prior to its routine implementation.

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Section: Discussionmentioning

confidence: 99%

Natural cycle frozen-thawed embryo transfer—can we improve cycle outcome?

Orvieto

Feldman

Lantsberg

et al. 2016

J Assist Reprod Genet

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“…In this regard, a recent meta analysis comparing outcomes between antagonist and agonist cycles, including 13 randomized clinical trials with a range of 2-101 pregnant cases for each study, miscarriage rates were not found to be different (11.7% vs 11.5%) [18]. However, the studies in this meta analysis in the Cochrane review did not take into account the plurality of gestations and the definitions of miscarriage were not uniform [5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Short Communicationmentioning

confidence: 83%

“…Possibly an endometrial impact could be attributed to this result. In this regard, some investigators also used GnRH agonist following embryo transfer after the administration of GnRH antagonists in ovarian stimulation phase in order to increase pregnancy rates [14].…”

Section: Short Communicationmentioning

confidence: 99%

Early pregnancy loss rates were different among singleton gestations conceived by ICSI using GnRH agonist and antagonist

Bahçeci

Uluğ

Şişmanoğlu

et al. 2009

J Assist Reprod Genet

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This study compared early pregnancy losses (termination of pregnancy before 12 weeks of gestation, EPL) among conceptions achieved by ICSI according to the type of GnRH analogue for ovarian stimulation. Only singleton gestations (2,184) and fresh embryo transfers were included. GnRH agonist was used in 848 gestations out of 2,184 and GnRH antagonist was used in the remaining 1,336 gestations. EPL was found to be significantly higher in GnRH antagonist gestations compared to GnRH agonist (27.2% vs 18.9%). This significant difference persisted when gestations were segregated according to maternal age, especially among women younger than 35 years old. Therefore our results suggest that gestations conceived by ovarian stimulation including GnRH antagonists may have higher propabilty of having EPL.

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“…Well-designed randomized clinical studies are required to clarify any effect of luteal GnRH agonist addition on pregnancy outcome measures with different doses, timing, and administration routes of GnRH agonists. (J Turk Ger Gynecol Assoc 2015; 16: 96-101) Keywords: GnRH agonist, luteal phase support, in vitro fertilization (IVF), progesterone Received: 23 February, 2015 Accepted: 06 April, 2015 Addition of gonadotropin releasing hormone agonist for luteal phase support in in-vitro fertilization: an analysis of 2739 cycles Abstract secretion were some of the proposed potential mechanisms of actions (13,14). The purpose of this study was to evaluate whether the addition of single-dose GnRH agonist to the progesterone for luteal support in IVF cycles improves the pregnancy outcome measures, particularly the live birth rates.…”

Section: Discussionmentioning

confidence: 99%

Addition of gonadotropin releasing hormone agonist for luteal phase support in in-vitro fertilization: an analysis of 2739 cycles

Şimşek

Kılıçdağ

Aytaç

et al. 2015

J Turkish German Gynecol Assoc

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Objective: Luteal phase is defective in in vitro fertilization (IVF) cycles, and many regimens were tried for the very best luteal phase support (LPS). Gonadotropin releasing hormone (GnRH) agonist use, which was administered as an adjunct to the luteal phase support in IVF cycles, was suggested to improve pregnancy outcome measures in certain randomized studies. We analyzed the effects of addition of GnRH agonist to standard progesterone luteal support on pregnancy outcome measures, particularly the live birth rates. Material and Methods:This is a retrospective cohort study, including 2739 IVF cycles. Long GnRH agonist and antagonist stimulation IVF cycles with cleavage-stage embryo transfer were included. Cycles were divided into two groups: Group A included cycles with single-dose GnRH agonist plus progesterone LPS and Group B included progesterone only LPS. Live birth rates were the primary outcome measures of the analysis. Miscarriage rates and multiple pregnancy rates were the secondary outcome measures.Results: Live birth rates were not statistically different in GnRH agonist plus progesterone (Group A) and progesterone only (Group B) groups in both the long agonist and antagonist stimulation arms (40.8%/41.2% and 32.8%/34.4%, p<0.05 respectively). Moreover, pregnancy rates, implantation rates, and miscarriage rates were found to be similar between groups. Multiple pregnancy rates in antagonist cycles were significantly higher in Group A than those in Group B (12.0% and 6.9%, respectively). Conclusion:A beneficial effect of a single dose of GnRH agonist administration as a luteal phase supporting agent is yet to be determined because of the wide heterogeneity of data present in literature. Well-designed randomized clinical studies are required to clarify any effect of luteal GnRH agonist addition on pregnancy outcome measures with different doses, timing, and administration routes of GnRH agonists. (J Turk Ger Gynecol Assoc 2015; 16: 96-101) Keywords: GnRH agonist, luteal phase support, in vitro fertilization (IVF), progesterone Received: 23 February, 2015 Accepted: 06 April, 2015 Addition of gonadotropin releasing hormone agonist for luteal phase support in in-vitro fertilization: an analysis of 2739 cycles Abstract secretion were some of the proposed potential mechanisms of actions (13,14). The purpose of this study was to evaluate whether the addition of single-dose GnRH agonist to the progesterone for luteal support in IVF cycles improves the pregnancy outcome measures, particularly the live birth rates. Material and Methods Study design and study populationThis study was a retrospective study conducted at

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Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles

Abstract: Luteal-phase GnRH agonist administration enhances ICSI clinical outcomes after GnRH agonist- and GnRH antagonist-treated ovarian stimulation cycles, possibly by a combination of effects on the embryo and the corpus luteum.

Cited by 135 publications

References 27 publications

Natural cycle frozen-thawed embryo transfer—can we improve cycle outcome?

Natural cycle frozen-thawed embryo transfer—can we improve cycle outcome?

Early pregnancy loss rates were different among singleton gestations conceived by ICSI using GnRH agonist and antagonist

Addition of gonadotropin releasing hormone agonist for luteal phase support in in-vitro fertilization: an analysis of 2739 cycles

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