Effects of gonadotropin-releasing hormone agonist pretreatment on frozen embryo transfer outcomes in artificial cycles: a meta-analysis

Li, Xueying; Lin, Jinli; Zhang, Linhao; Liu, Yao

doi:10.1007/s00404-022-06823-7

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…It can also improve the reproductive outcomes for older patients (aged 36–43 years) who in experience recurrent implantation failure in FET cycles ( 25 ). Prior treatment with GnRHa in FET can enhance the chances of successful clinical pregnancy, live birth, and implantation, particularly in individuals who have experienced multiple failed implantation attempts ( 26 ). A study also showed that there were no statistically significant differences in clinical pregnancy, live birth, abortion, multiple pregnancy, and biochemical pregnancy rates in patients with endometriosis between the two protocols ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

The effect of gonadotropin-releasing hormone agonist downregulation in conjunction with hormone replacement therapy on endometrial preparation in patients for frozen–thawed embryo transfer

Hao,

Li,

Zhang

et al. 2024

Front. Med.

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ObjectiveTo investigate the effects of combining gonadotropin-releasing hormone agonist (GnRHa) downregulation with hormone replacement therapy (HRT, GnRHa-HRT) on the clinical outcomes of patients undergoing frozen–thawed embryo transfer (FET).MethodsIn this retrospective study, we included patients who had FET between January 2018 and December 2022. They were categorized into HRT and GnRHa-HRT groups based on the endometrial preparation protocol. The study compared the clinical outcomes of patients in two groups. Possible factors affecting clinical outcomes were analyzed using univariate analysis. To analyze the impact of two endometrial preparation methods on clinical outcomes, multifactorial logistic regression was performed.ResultsThe rates of clinical pregnancy (47.31% vs. 59.60%), embryo implantation (37.58% vs. 49.65%), biochemical pregnancy (52.36% vs. 64.31%), and early abortion (7.07% vs. 10.77%) were statistically different between the two groups (p < 0.05). Analysis using multifactorial logistic regression showed that there was a 1.65-fold increase in clinical pregnancy rates (OR = 1.65, 95% CI: 1.29–2.12, p < 0.001) and a 1.55-fold increase in embryo implantation rates (OR = 1.55, 95% CI: 1.27–1.90, p < 0.001) in the GnRHa-HRT group when compared to the HRT group. For blastocyst transfer, the clinical pregnancy and implantation rates of the GnRHa-HRT group were significantly higher than those of the HRT group (OR = 1.75, 95% CI: 1.30–2.37, p < 0.001; OR = 1.73, 95% CI: 1.35–2.21, p < 0.001).ConclusionIn FET cycles, leuprorelin (as a GnRHa) downregulation combined with HRT may improve the clinical outcome of patients compared to the HRT cycle, especially for the clinical pregnancy and embryo implantation rates of patients with blastocyst transfer.

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Section: Discussionmentioning

confidence: 99%

The effect of gonadotropin-releasing hormone agonist downregulation in conjunction with hormone replacement therapy on endometrial preparation in patients for frozen–thawed embryo transfer

Hao,

Li,

Zhang

et al. 2024

Front. Med.

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“…FET is commonly used in ART due to various reasons including unsuitability of endometrial for fresh cycle transfer, high risk of ovarian hyperstimulation syndrome in fresh cycles, and promotion of cumulative live birth rate [23]. The rate of FET performed in patients with endometrosis was about 41% and the rate of fresh transplantation was about 59% [24].…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of the endometrial preparation protocols for frozen-thawed embryo transfer cycles in women with endometriosis

Yang,

Wen,

et al. 2023

Reprod Biol Endocrinol

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Background There was inconsistency in optimal endometrial preparation protocol for frozen-thawed embryo transfer (FET) in patients with endometriosis. We conducted this study to investigate the effect of different endometrial preparation protocols on the pregnancy outcomes in patients with endometriosis undergoing FET cycles, and determine the optimal number of GnRHa injections in GnRHa-HRT protocols. Method(s) This was a retrospective cohort analysis of women with endometriosis who underwent FET cycles at a single university-based center. This study retrospectively analyzed 2048 FET cycles in our center from 2011 to 2020. According to the endometrial preparation protocols, patients were divided into 4 groups: gonadotropin releasing hormone agonist-hormone replacement therapy(GnRHa-HRT), hormone replacement therapy(HRT), ovulation induction(OI), and natural cycle(NC). In the GnRHa-HRT group, patients were further divided into 3 groups: one injection of GnRHa, two injections of GnRHa, and three or more injections of GnRHa. The primary outcome was the clinical pregnancy rate. Propensity score matching was used to adjust for potential non-similarities among the groups. Multivariate logistic regression analysis was performed to figure out the risk factors for pregnancy outcomes. Result(s) There were no statistical differences in pregnancy outcomes among the four endometrial preparation protocols in FET cycles with endometriosis patients, the results retained after propensity score matching(PSM). And in endometriosis patients complicated with adenomyosis, the results remained similar. In patients with GnRHa-HRT protocol, there were no differences in clinical pregnancy rate and live birth rate with different numbers of GnRHa injections, the early miscarriage rate were 18% in the two injections of GnRHa group and 6.5% in the one injection of GnRHa group(P = 0.017). Multifactorial logistic regression analysis showed that two injections of GnRHa before FET was associated with increased early miscarriage rate compared with one injection of GnRHa[adjusted OR (95% CI): 3.116(1.079–8.998),p = 0.036]. Conclusion(s) The four kinds of endometrial preparation protocols for FET, GnRHa-HRT, HRT, OI and NC had similar pregnancy outcomes in patients with endometriosis. In endometriosis patients complicated with adenomyosis, the results remained similar. In patients with endometriosis undergoing GnRHa-HRT protocol for FET, more injections of GnRHa had no more advantages in pregnancy outcomes, on the contrary, it might increase the early miscarriage rate.

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“…GnRHa downregulation combined with HRT cycles has been increasingly used in recent years. Although the e cacy of GnRHa pretreatment is controversial (20,21), a recent systematic review and metaanalysis of 27 articles with 14152 patients reported that HRT cycles with GnRHa suppression were associated with an increased live birth rate and clinical pregnancy rate compared to those without GnRHa suppression (22). Additionally, some studies have demonstrated that GnRHa pretreatment in HRT cycles may have a bene cial effect on speci c groups, such as adenomyosis (23,24), recurrent implantation failure (RIF) (25,26) and thin endometrium (27).…”

Section: Introductionmentioning

confidence: 99%

Additional single dose GnRH agonist during luteal phase support may improve live birth rate in GnRHa-HRT frozen–thawed embryo transfer cycle: a retrospective cohort study

Chang

Lin

et al. 2023

Preprint

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Background GnRH agonist (GnRHa) has been reported to have direct effects and functional roles in the endometrium and embryos. Several meta-analyses have shown that GnRHa administration in the luteal phase improved the live birth rate or pregnancy rate in both fresh and frozen embryo transfer (FET) cycles. The aim of this study was to investigate whether luteal GnRHa administration could also improve in vitro fertilization (IVF) outcomes in patients undergoing hormone replacement therapy (HRT) cycles with GnRHa suppression. Methods The retrospective cohort study included a total of 414 patients undergoing GnRHa-HRT FET cycles. The study group included 216 patients receiving an additional single dose of GnRHa in the luteal phase following embryo transfer. A total of 198 patients in the control group did not receive luteal GnRHa. The baseline and cycle characteristics and reproductive outcomes were compared between the two groups. Results Baseline and cycle characteristics were similar between the two groups, except lower AMH levels were found in the luteal GnRHa group than in the control group. The luteal GnRHa group had a significantly higher ongoing pregnancy rate and live birth rate than the control group. The multivariate analysis revealed that luteal GnRHa administration was positively associated with ongoing pregnancy (OR 1.66, 95% CI 1.01–2.72, P = 0.048) and live birth (OR 1.67, 95% CI 1.01–2.75, P = 0.044). When the subgroup of patients with recurrent implantation failure (RIF) was analyzed, the multivariate analysis also showed that luteal GnRHa administration had beneficial effects on ongoing pregnancy (OR 2.79, 95% CI 1.14–6.82, P = 0.024) and live birth (OR 2.89, 95% CI 1.15–7.22, P = 0.023). Conclusions Our data suggest that the addition of one luteal dose of GnRHa may improve the live birth rate in patients undergoing the GnRHa-HRT protocol, especially in RIF patients.

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Effects of gonadotropin-releasing hormone agonist pretreatment on frozen embryo transfer outcomes in artificial cycles: a meta-analysis

Cited by 6 publications

References 23 publications

The effect of gonadotropin-releasing hormone agonist downregulation in conjunction with hormone replacement therapy on endometrial preparation in patients for frozen–thawed embryo transfer

The effect of gonadotropin-releasing hormone agonist downregulation in conjunction with hormone replacement therapy on endometrial preparation in patients for frozen–thawed embryo transfer

Retrospective analysis of the endometrial preparation protocols for frozen-thawed embryo transfer cycles in women with endometriosis

Additional single dose GnRH agonist during luteal phase support may improve live birth rate in GnRHa-HRT frozen–thawed embryo transfer cycle: a retrospective cohort study

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