GnRH-agonist pretreatment in hormone replacement therapy improves pregnancy outcomes in women with male-factor infertility

Abstract

ObjectiveThis study aimed to examine the efficacy of HRT with gonadotropin-releasing hormone agonist (GnRH-a) pre-treatment in women with male-factor infertility who underwent a frozen embryo transfer (FET) programme.DesignBetween January 2016 and October 2020, 2733 women with male-factor infertility who underwent the HRT protocol as the endometrial preparation method were enrolled at two Reproductive Medicine Centres. Patients were divided into two groups based on whether they had GnRH-a pre-treatment before HRTs: the GnRHa-HRT group and the HRT group. The inverse probability of treatment weighting (IPTW) method was conducted to balance patient baseline characteristics between treatment cohorts to reduce selection bias. The live birth rate was considered regarded as the primary pregnancy outcome.ResultsMultivariate logistic regression adjusted for confounding factors, the GnRHa-HRT group showed a notably higher rate of live birth (OR 2.154, 95% CI 1.636~2.835, P<0.001) when compared to the HRT group. Additionally, the rate of miscarriage was significantly lower in the GnRHa-HRT group. The GnRHa-HRT group had significantly higher rates of biochemical pregnancy, clinical pregnancy, multiple pregnancy, and term birth.ConclusionThe endometrial preparation protocol of HRT with GnRH-a pre-treatment could obviously increase the live birth rate for women with male-factor infertility undergoing the FET programme.

Effect of GnRH agonist down-regulation combined with hormone replacement treatment on reproductive outcomes of frozen blastocyst transfer cycles in women of different ages

“…And GnRH-a can improve pregnancy outcomes in patients with male-factor infertility in FET cycles. It may be that it can facilitate dialogue between embryo and endometrium ( Yu et al, 2022 ). It has been reported that pre-pregnancy BMI affects ART pregnancy outcomes.…”

Impact of gonadotropin-releasing hormone agonist and hormone replacement therapy on pregnancy outcomes in single euploid frozen-thawed embryo transfer for patients with endometrial polyps

“…In contrast, one prospective randomized trial uncovered that GnRHa-HRT was associated with significantly higher pregnancy (37.6% vs. 24%, odds ratio [OR] 1.8, 95% credible intervals [CI] 1.1-3.4), clinical pregnancy (24% vs. 11.3%, OR 2.5, 95% CI 1.2-5.5), and live birth (20% vs. 8.5%, OR 2.9, 95% CI 1.2-8) rates in patients with regular menstruation undergoing frozen-thawed cleavage-stage embryo transfer [23] . In addition, multiple retrospective studies have not achieved definitive conclusions [24][25][26][27][28][29] .…”

Editorial: Exploring the optimal endometrial preparation protocol for frozen-thawed embryo transfer

“…The researchers who contributed to this Research Topic have published a total of 11 thematic articles, including 1 review, 2 meta-analyses, 7 original research articles, and 1 study protocol, which highlight optimal endometrial preparation protocols. Hormone replacement therapy (HRT) is currently the most widely used treatment due to its broad applicability and low cycle cancellation rate ( 3 ). Nevertheless, it is associated with an increased risk of complications during obstetrics and delivery ( 4 ).…”