Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study

Işık, Ahmet Zeki; Çağlar, Gamze Sinem; Sözen, Eran; Akarsu, Cem; Tuncay, Görkem; Özbicer, T.; Vıcdan, Kubilay

doi:10.1016/j.rbmo.2009.04.001

Cited by 48 publications

(59 citation statements)

References 21 publications

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“…However, only in GnRH antagonist cycles a significant increase in the OP was observed (16). Subsequent studies demonstrated that LP GnRHa supplementation seemed to benefit the GnRH antagonist co-treated cycle (8, 16, 25–27) more than the long GnRHa co-treated cycle (18, 19, 28). The main reason for this is the down-regulation of the pituitary, which is induced by the long GnRHa protocol (28).…”

Section: Discussionmentioning

confidence: 99%

Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial

Benmachiche¹,

Benbouhedja²,

Zoghmar³

et al. 2017

Front. Endocrinol.

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ObjectiveTo explore whether the addition of a mid-luteal bolus of GnRH agonist (GnRHa) improves the implantation rate (IR) in in vitro fertilization (IVF) cycles.DesignA randomized controlled trial.SettingPrivate IVF center.Patients328 IVF/intracytoplasmic sperm injection patients were triggered with GnRHa and received 1,500 IU HCG on the day of oocyte pick-up (OPU) in addition to a standard luteal phase support (LPS).Intervention(s)In addition, the study group received a bolus of GnRHa 6 days after OPU, whereas the control group did not.Main outcome measureImplantation rate.Secondary outcome measure(s)Ongoing pregnancy (OP) and live birth (LB) rates.ResultsAlthough serum concentrations of FSH, LH, E2, and P on day OPU + 7 were significantly higher in the study group compared to the control group, the IR was not statistically different between the treatment group (27%) and the control group (23%) [odds ratio (OR) 1.2 (95% CI 0.9–1.7), P < 0.27]. Similarly, the OP rate was 37% in the treatment group and 31% in the control group [OR 1.3 (95% CI 0.8–2.0), P < 0.23]. The LB rate was 36% in the treatment group and 31% in the control group [OR: 1.3 (95% CI 0.8–2.0), P < 0.27].ConclusionAlthough a trend toward a higher IR and pregnancy rate was observed in the treatment group, this difference was not statistically significant. However, the absolute risk difference of 5% found for LB is clinically relevant, warranting further investigation.NCT02053779.

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Section: Discussionmentioning

confidence: 99%

Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial

Benmachiche¹,

Benbouhedja²,

Zoghmar³

et al. 2017

Front. Endocrinol.

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“…In a randomized control trial, 164 patients in GnRH antagonist protocol who underwent intracytoplasmic sperm injection (ICSI) after ovarian stimulation were randomized to either P alone or GnRH agonist in addition to P for luteal phase support. Although the numbers and grades of embryos transfered were similar in the two groups, the patients with additional GnRH agonist supplementation had significantly higher implantation, clinical pregnancy, and live birth rates (36).…”

Section: Regulation Of Implantationmentioning

confidence: 83%

“…Increased implantation and pregnancy rates in ART cycles that used GnRH agonist for additional luteal phase support also imply potential local effect from endometrial GnRH receptors (36). In a randomized control trial, 164 patients in GnRH antagonist protocol who underwent intracytoplasmic sperm injection (ICSI) after ovarian stimulation were randomized to either P alone or GnRH agonist in addition to P for luteal phase support.…”

Section: Regulation Of Implantationmentioning

confidence: 99%

The role of peripheral gonadotropin-releasing hormone receptors in female reproduction

Ruman

Christman

2011

Fertility and Sterility

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“…Group (22) reported a study in which patients were blindly randomized to the addition of single-dose 0.5 mg leuprolide acetate or hCG plus progesterone groups (22). Implantation rate and live birth rates were reported to be significantly improved by GnRH agonist addition (26.5% vs. 9.3% and 35.1% vs. 16.3%, respectively).…”

Section: Total Cycles N=9470mentioning

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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Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study

Cited by 48 publications

References 21 publications

Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial

Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial

The role of peripheral gonadotropin-releasing hormone receptors in female reproduction

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

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