Download fulltext HTML
Eftekhar, M., Mirzaei, M., Mangoli, E., & Mehrolhasani, Y. (2021). Effects of multiple doses of gonadotropin-releasing hormone agonist on the luteal-phase support in assisted reproductive cycles: A clinical trial study. International Journal of Reproductive BioMedicine (IJRM), 19(7), 645–652. https://doi.org/10.18502/ijrm.v19i7.9475

https://doi.org/10.18502/ijrm.v19i7.9475

statistics

  • 194 Abstract Views
  • 83 PDF Views
  • 0 HTML Views
  • Cited by 1 article

authors

  • Maryam Eftekhar

    Maryam Eftekhar

    Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  • Maryam Mirzaei

    Maryam Mirzaei

    Department of Obstetrics and Gynecology, Jiroft University of Medical Sciences, Jiroft, Kerman, Iran
    https://orcid.org/0000-0002-0359-4305
  • Esmat Mangoli

    Esmat Mangoli

    Department of Reproductive Biology, Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
    https://orcid.org/0000-0001-6206-7831
  • Yasamin Mehrolhasani

    Yasamin Mehrolhasani

    Department of Obstetrics and Gynecology, Bam University of Medical Sciences, Bam, Kerman, Iran

Published Date

  • Aug 16, 2021

Effects of multiple doses of gonadotropin-releasing hormone agonist on the luteal-phase support in assisted reproductive cycles: A clinical trial study

International Journal of Reproductive BioMedicine (IJRM) / International Journal of Reproductive BioMedicine (IJRM): Volume 19, Issue No. 7 / Pages 645–652

Abstract

Background: The effect of adding gonadotropin-releasing hormone (GnRH) agonist on the luteal phase support in assisted reproductive technique (ART) cycles is controversial.


Objective: To determine the effects of adding multiple doses of GnRH agonist to the routine luteal phase support on ART cycle outcomes.


Materials and Methods: This clinical trial study included 200 participants who underwent the antagonist protocol at the Research and Clinical Center for Infertility, Yazd, Iran, between January and March 2020. Of the 200, 168 cases who met the inclusion criteria were equally divided into two groups – the case and the control groups. Both groups received progesterone in the luteal phase, following which the case group received GnRH agonist subcutaneously (0/1 mg triptorelin) zero, three, and six days after the fresh embryo transfer, while the control group did not receive anything. Finally, chemical and clinical pregnancy rates, number of mature oocytes, fertilization rate, total dose of gonadotropin, and the estradiol level were determined.


Results: The baseline characteristics were similar in both groups. No significant difference was observed between embryo transfer cycles. Clinical results showed that differences between the fertilization rate, chemical and clinical pregnancies were not significant.


Conclusion: The results showed that receiving multiple doses of GnRH agonist in the luteal phase of ART cycles neither improves embryo implantation nor the pregnancy rates; therefore, further studies are required.


Key words: Luteal phase, GnRH agonist, ART, Pregnancy rate.

References
[1] Griesinger G, Meldrum D. Introduction: Management of the luteal phase in assisted reproductive technology. Fertilit Steril 2018; 109: 747–748.

[2] Hossain A, Phelps J, Agarwal A, Sanz E, Mahadevan M. A review of the society for assisted reproductive technology embryo grading system and proposed modification. Int J Fertil Steril 2016; 10: 141–147.

[3] Fatemi HM. Simplifying luteal phase support in stimulated assisted reproduction cycles. Fertil Steril 2018; 110: 1035–1036.

[4] de Ziegler D, Ayoubi JM, Frydman R, Fanchin R. Luteal phase support in assisted reproductive technologies: From here to there. Fertil Steril 2018; 109: 57–58.

[5] Martins WP, Ferriani RA, Navarro P, Nastri CO. GnRH agonist during luteal phase in women undergoing assisted reproductive techniques: Systematic review and meta−analysis of randomized controlled trials. Ultrasound Obstet Gynecol 2016; 47: 144–151.

[6] Davar R, Farid Mojtahedi M, Miraj S. Effects of single dose GnRH agonist as luteal support on pregnancy outcome in frozen-thawed embryo transfer cycles: An RCT. Iran J Reprod Med 2015; 13: 483–488.

[7] Mendoza-Tesarik R, Mendoza N, López CC, Tesarik J. GnRH agonist treatment of luteal phase deficiency in HCG-triggered IVF cycles: A matched case-control study. Reprod Biomed Online 2019; 39: 225–230.

[8] Yıldız GA, Şükür YE, Ateş C, Aytaç R. The addition of gonadotrophin releasing hormone agonist to routine luteal phase support in intracytoplasmic sperm injection and embryo transfer cycles: A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol 2014; 182: 66–70.

[9] Fusi FM, Arnoldi M, Bosisio C, Lombardo G, Ferrario M, Zanga L, et al. Ovulation induction and luteal support with GnRH agonist in patients at high risk for hyperstimulation syndrome. Gynecol Endocrinol 2015; 31: 693–697.

[10] Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Hum Reprod 2017; 32: 1786–1801.

[11] Mengling Song CL, Rong Hu, Feimiao Wang, Zhenghao Huo. Administration effects of singledose GnRH agonist for luteal support in females undertaking IVF/ICSI cycles: A meta-analysis of randomized controlled trials. Exp Ther Med 2020; 19: 786–796.

[12] Ma X, Du W, Hu J, Yang Y, Zhang X. Effect of gonadotrophin-releasing hormone agonist addition for luteal support on pregnancy outcome in vitro fertilization/intracytoplasmic sperm injection cycles: A meta-analysis based on randomized controlled trials. Gynecol Obstet Invest 2020; 85: 13–25.

[13] Tesarik J, Hazout A, Mendoza-Tesarik R, Mendoza N, Mendoza C. Beneficial effect of lutealphase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist-and antagonist-treated ovarian stimulation cycles. Hum Reprod 2006; 21: 2572–2579.

[14] Zafardoust S, Jeddi-Tehrani M, Akhondi MM, Sadeghi MR, Kamali K, Mokhtar S, et al. Effect of administration of single dose GnRH agonist in luteal phase on outcome of ICSI-ET cycles in women with previous history of IVF/ICSI failure: A randomized controlled trial. J Reprod Infertil 2015; 16: 96–101.

[15] Jianyuan Song CD, Wangyu Cai, Wei Wu, Houyi LV, Jian Xu. Comparison of GnRH-a prolonged protocol and short GnRH-a long protocol in patients with thin endometrium for assisted reproduction: A retrospective cohort study. Drug Des Devel Ther 2020; 14: 3673–3682.

[16] Li DQY. Multiple-dose versus single-dose gonadotropin-releasing hormone agonist after first in vitro fertilization failure associated with luteal phase deficiency: A randomized controlled trial. J Int Med Res 2020; 48: 1–11.

[17] Aboulghar MA, Marie H, Amin YM, Aboulghar MM, Nasr A, Serour GI, et al. GnRH agonist plus vaginal progesterone for luteal phase support in ICSI cycles: A randomized study. Reprod Biomed Online 2015; 30: 52–56.

[18] Davar R, Dashti S, Omidi M. Endometrial preparation using gonadotropin-releasing hormone agonist prior to frozen-thawed embryo transfer in women with repeated implantation failure: An RCT. Int J Reprod Biomed 2020; 18: 319–326.

[19] Wiser A, Klement AH, Shavit T, Berkovitz A, Koren RR, Gonen O, et al. Repeated GnRH agonist doses for luteal support: A proof of concept. Reprod Biomed Online 2019; 39: 770–776.

[20] Kung HF, Chen MJ, Guua HF, Chen YF, Yi YC, Ho JYP, et al. Luteal phase support with decapeptyl improves pregnancy outcomes in intracytoplasmic sperm injection with higher basal follicle-stimulating hormone or lower mature oocytes. J Chin Med Assoc 2014; 77: 524–530.

[21] Tesarik J, Mendoza-Tesarik R, Mendoza N. Gonadotropin-releasing hormone agonist for luteal phase support: The origin of the concept, current experience, mechanism of action and future perspectives. Fertil Steril 2016; 106: 268– 269.