Influence of Different Gonadotropin-releasing Hormone Agonist Administration Methods on Pregnancy Outcomes of Patients Undergoing In-vitro Fertilization-embryo Transfer

Curr Med Sci. 2019 Jun;39(3):437-441. doi: 10.1007/s11596-019-2056-9. Epub 2019 Jun 17.

Abstract

This study aimed to investigate the effect of different gonadotropin-releasing hormone agonist (GnRH-a) administration methods on pregnancy outcomes of patients undergoing in-vitro fertilization-embryo transfer (IVF-ET). Clinical data of 5217 patients who underwent IVF-ET were retrospectively analyzed. Patients were divided into the long-acting GnRH-a group (n=1330) and the short-acting GnRH-a group (n=3887) based on their various treatment plans. The clinical and laboratory embryo data and clinical pregnancy outcomes were compared between the two groups. The results showed that there were no significant differences in the age, infertility, primary/secondary infertility rate, IVF rate, body mass index (BMI), antral follicle counting (AFC), follicle-stimulating hormone (FSH) level, and the number of transplanted embryos between the two groups (P>0.05). There were no significant differences in the oocyte numbers, MII rate, fertilization rate, cleavage rate and blastocyst formation rate (P>0.05) between the two groups. The gonadotropin (Gn) using days, Gn dose and endometrial thickness were significantly greater in the long-acting GnRH-a group than those in the short-acting GnRH-a group (P<0.01). Additionally, the estradiol (E2) levels, blastocyst freezing rate, embryo utilization rate, transplant cancellation rate and abortion rate were significantly lower in the long-acting GnRH-a group than those in the short-acting GnRH-a group (P<0.01). The clinical pregnancy rate and embryo implantation rate were significantly higher in the long-acting GnRH-a group than in the short-acting GnRH-a group (P<0.01). It was concluded that use of long-acting GnRH-a can effectively reduce the transplant cancellation rate and improve the clinical pregnancy rate of the fresh cycle.

Keywords: clinical pregnancy rate; gonadotropin-releasing hormone agonist; in-vitro fertilization-embryo transfer; long-acting; short-acting.

MeSH terms

  • Abortion, Spontaneous / diagnosis
  • Adult
  • Chorionic Gonadotropin / administration & dosage
  • Delayed-Action Preparations / therapeutic use*
  • Embryo Transfer / methods
  • Estradiol / blood
  • Female
  • Fertility Agents, Female / therapeutic use*
  • Fertilization in Vitro / methods
  • Follicle Stimulating Hormone / blood
  • Gene Expression
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors
  • Gonadotropin-Releasing Hormone / genetics
  • Gonadotropin-Releasing Hormone / metabolism
  • Hormone Antagonists / therapeutic use*
  • Humans
  • Infertility, Female / diagnosis
  • Infertility, Female / metabolism
  • Infertility, Female / physiopathology
  • Infertility, Female / therapy*
  • Male
  • Ovary / drug effects
  • Ovary / metabolism
  • Ovary / physiopathology
  • Ovulation Induction / methods*
  • Pregnancy
  • Pregnancy Rate
  • Prospective Studies
  • Sperm Injections, Intracytoplasmic / methods
  • Treatment Outcome

Substances

  • Chorionic Gonadotropin
  • Delayed-Action Preparations
  • Fertility Agents, Female
  • Hormone Antagonists
  • Gonadotropin-Releasing Hormone
  • Estradiol
  • Follicle Stimulating Hormone