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

Abstract

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.

Prevalence, consequence, and significance of reverse cleavage by human embryos viewed with the use of the Embryoscope time-lapse video system

“…RC did not appear to be associated with the woman's age at the time of the egg collection, but with the regimen used for ovarian stimulation, with RC seen more frequently in cycles with the use of GnRH antagonists than those with GnRH agonists. Although no conclusive data are available from earlier studies comparing embryology and clinical results following cycles using these two ovarian-stimulating protocols (24,(26)(27)(28)(29)(30), the two regimens did not seem to be equivalent for different patient groups (31)(32)(33)(34). The impact on the ovary and hence the oocyte is also implied indirectly with the follicular fluid concentrations of insulin-like growth factors and their binding proteins being different following the different protocols (35).…”

Effect of Helicobacter pylori infection on pregnancy rates and early pregnancy loss after intracytoplasmic sperm injection

“…Various factors have been comprehensively reported to contribute to EPL in ICSI, including overweight, 22 ovarian stimulation with GnRH antagonists, 23 maternal age, 9 smoking, and the transfer of poor quality embryos. 21 Based on our data, we postulate that other causes of EPL following ICSI include infection with H. pylori CagA-positive strains and tubal factor and ovulation disorder.…”

The GnRH Antagonist Protocol is Associated with a Higher Embryo Aneuploidy Rate Than the GnRH Agonist Long Protocol in Chinese Women

“…It has been reported that in a general IVF population, GnRH-ant protocol is associated with lower ongoing pregnancy rates than the GnRH-a long protocol [14,35]. Studies have also suggested that embryos conceived after receiving GnRH antagonists may be associated with higher early pregnancy loss rates [15][16][17]. It is evident that aneuploidy is a major factor that results in early pregnancy loss [19].…”

“…This meta-analysis con rmed that compared to the GnRH-a long protocol, the GnRH-ant protocol was associated with lower ongoing pregnancy rates in a general IVF population but did not seem to compromise ongoing pregnancy rates in individuals with polycystic ovarian syndrome (PCOS) and poor responders. Studies also suggest that embryos conceived after GnRH antagonists may have higher early pregnancy loss rates [15][16][17]. Furthermore, the Chinese birth cohort study on ART and birth defects published in The Lancet Regional Health, 2021, showed that the GnRH-ant regimen for ovulation induction in women was associated with an increased risk of birth defects in their offspring [18].…”