GnRH agonist versus GnRH antagonist in ovarian stimulation: the role of endometrial receptivity

Orvieto, Raoul; Meltzer, S; Rabinson, Jacob; Zohav, Efraim; Anteby, Eyal Y.; Nahum, Ravit

doi:10.1016/j.fertnstert.2007.10.022

Cited by 47 publications

(43 citation statements)

References 18 publications

(23 reference statements)

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“…In this regard, a recent meta analysis comparing outcomes between antagonist and agonist cycles, including 13 randomized clinical trials with a range of 2-101 pregnant cases for each study, miscarriage rates were not found to be different (11.7% vs 11.5%) [18]. However, the studies in this meta analysis in the Cochrane review did not take into account the plurality of gestations and the definitions of miscarriage were not uniform [5][6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Short Communicationmentioning

confidence: 83%

“…In order to determine whether this subtle clinical outcome difference between those GnRH analogues could be integral to endometrial microenvironment, some studies addressed endometrium as a confounding factor. Histologically no apparent differences were found enough to detect any deleterious effects of GnRH antagonists; others found significant ultrastructural differences such as different expressions of growth factors and chemokins from endometrial cells exposed to GnRH agonists and antagonists [9][10][11][12]. Bearing in mind that GnRH receptors exist on endometrium, it may be speculated that endometrial factor could be related to this clinical outcome difference between GnRH agonists and antagonists.…”

Section: Short Communicationmentioning

confidence: 99%

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

Bahçeci

Uluğ

Şişmanoğlu

et al. 2009

J Assist Reprod Genet

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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.

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Section: Short Communicationmentioning

confidence: 83%

Section: Short Communicationmentioning

confidence: 99%

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

Bahçeci

Uluğ

Şişmanoğlu

et al. 2009

J Assist Reprod Genet

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“…This ratio was significantly higher in the D1-hCG treatment group compared to Controls. Yet, several studies consider top quality embryos those with higher implantation ability [33], Check et al [34] analyzed a single embryo transfer data basis and reported that six, seven or eight-cell embryos produces similar pregnancy rates. Consequently, the translation of D1-hCG's better quality embryos into a significantly improved biochemical pregnancy rate, implantation rate, and on-going pregnancy rate per transfer might still under debate and scientific testing.…”

Section: Discussionmentioning

confidence: 99%

Human choriogonadotropin prior to controlled ovarian stimulation and in vitro fertilization improves implantation, and pregnancy rates

Motta

Smith

Serafini

et al. 2009

J Assist Reprod Genet

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Purpose Our purpose was to retrospectively compare controlled ovarian stimulation(COH) in IVF cycles with administration of hCG on the day of menses (D1-hCG) with women not receiving hCG at day 1 of menses (Control). Methods Data on maternal age, endocrine profile, amount of rFSH required, embryo characteristics, implantation and pregnancy rates were recorded for comparison between D1-hCG (n=36) and Control (n=64). Results Dose of rFSH required to accomplish COH was significantly lower in D1-hCG. Following ICSI, more topquality embryos were available for transfer per patient in the D1-hCG and biochemical pregnancy rates per transfer were significantly higher in the D1-hCG. Significantly higher implantation and on-going pregnancy rates per embryo transfer were observed in D1-hCG (64%) compared to Control (41%). Conclusions Administration of D1-hCG prior to COH reduces rFSH use and enhances oocyte developmental competence to obtain top quality embryos, and improves implantation and on-going pregnancy rates. At present it is not clear if the benefit is related to producing an embryo that more likely to implant or a more receptive uterus, or merely fortuitous and related to the relatively small power of the study.

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“…2 Several studies have been conducted to evaluate the effect of controlled ovarian hyperstimulation with GnRH agonist and antagonist on endometrium receptivity or implantation with conflicting results. [3][4][5][6][7][8] Moreover, GnRH antagonist for pituitary down regulation during ovulation induction has been seen to directly act on extra pituitary receptor, including the endometrium and has been associated with decrease endometrial receptivity. 9 There are few studies examining the association between endometrial receptivity measured in the form of endometrial blood flow with colour Doppler and clinical outcome in the GnRH antagonist protocol.…”

Section: Introductionmentioning

confidence: 99%

Analysis of endometrial blood flow with color Doppler energy in predicting outcome in GnRH antagonist down regulated ICSI/IVF cycles: a prospective cohort study setting

R¹,

Yang²,

Yong³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: The study was conducted to assess the association between endometrial blood flow pattern assessed with colour Doppler around the day of HCG administration and IVF outcome following GnRH antagonist down regulated cycles.Methods: It was a prospective, cohort study. Total of sixty-eight patients undergoing IVF-ET/ICSI were recruited in the study. All the patients underwent controlled ovarian stimulation with a step-up protocol, and GnRH antagonists were used for down-regulation. Transvaginal ultrasound measurements of all patients were performed on the day of HCG injection. A 6.5 MHz pulsed Doppler system was used for blood flow analysis. Bilateral uterine arteries, pulsatility index and resistance index were calculated along with uterine artery peak systolic velocity on both sides. Endometrial blood flow was analysed by detecting flow in the intra-endometrial or the adjacent sub-endometrial regions.Results: Baseline FSH in pregnant group was lower (6.29) than non-pregnant group (7.36). The overall pregnancy rate was 45.6% (n=31) and the ongoing pregnancy rate was 41.1% (n=28). Total of 57 patients out of 68 patients had both good endometrial and sub-endometrial blood flow. The overall pregnancy rate in this group was 47.3%. Similarly, in patients who had minimal endometrial and sub-endometrial blood flow the pregnancy rate was 37.5%. There was no significant correlation between pregnancy outcomes and the color flow Doppler parameters such as average uterine PI, average uterine RI and right/left uterine peak systolic velocity.Conclusion: Uterine artery PI, RI and PSV has no role in predicting endometrial receptivity and thus pregnancy outcome in IVF-ET cycle, however those patient with good endometrial and sub-endometrial flow have higher pregnancy rate than those with minimal flow rate.

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GnRH agonist versus GnRH antagonist in ovarian stimulation: the role of endometrial receptivity

Cited by 47 publications

References 18 publications

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

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

Human choriogonadotropin prior to controlled ovarian stimulation and in vitro fertilization improves implantation, and pregnancy rates

Analysis of endometrial blood flow with color Doppler energy in predicting outcome in GnRH antagonist down regulated ICSI/IVF cycles: a prospective cohort study setting

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