Vol 94, No 5 (2023)
Research paper
Published online: 2022-08-23

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GnRH agonist administration as luteal support on the transfer day of single blastocyst in dual-triggered cycles

Ahmet Demir1, Can Köse1, Ebru Şahin Güleç1, Pınar Türkmen1, Emrah Töz1, Nuri Peker2
Pubmed: 35997216
Ginekol Pol 2023;94(5):374-388.

Abstract

Objectives: Luteal phase support with gonadotropin-releasing hormone agonist (GnRH-a) has been considered in terms of its potential beneficial effects on in vitro fertilisation (IVF) cycles. In our study, we assessed the effectiveness of single-dose GnRH-a administration in dual-triggered cycles on pregnancy outcomes.
Material and methods: Eighty women who underwent intra cytoplasmic sperm injection (ICSI) cycle and had fresh blastocyst transfer were divided into two groups in terms of luteal phase support. The study group (Group A) consisted of patients (n = 40) who received a single-dose GnRH-a injection (0.1 mg of triptorelin acetate) subcutaneously 6 days after oocyte retrieval in addition to 600 mg daily of micronised progesterone, and the control group (Group B) comprised of patients (n = 40) taking 600 mg micronised progesterone daily from the first day after oocyte retrieval. GnRH-a and human chorionic gonadotropin (hCG; dual trigger) were administered to all patients. Comparison of the clinical pregnancy and live birth rates was our main goal.
Results: There was no significant difference between the two groups in terms of β-hCG positivity rates, clinical pregnancy rates and live birth rates (p value for beta-hCG = 0.25, clinical pregnancy = 0.80, live birth = 0.45).
Conclusions: Our study demonstrated that in dual triggered cycles administration of a single dose of GnRH-a on the transfer day of a single blastocyst in addition to routine luteal phase support with progesterone does not statistically increase implantation, clinical pregnancy or live birth rates.

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References

  1. van der Linden M, Buckingham K, Farquhar C, et al. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2011(10): CD009154.
  2. Wiser A, Klement AH, Shavit T, et al. Repeated GnRH agonist doses for luteal support: a proof of concept. Reprod Biomed Online. 2019; 39(5): 770–776.
  3. Ferraretti AP, La Marca A, Fauser BC, et al. ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011; 26(7): 1616–1624.
  4. Bar Hava I, Yafee H, Omer Y, et al. GnRHa for trigger and luteal phase support in natural cycle frozen embryo transfer - A proof of concept study. Reprod Biol. 2020; 20(3): 282–287.
  5. Pirard C, Donnez J, Loumaye E. GnRH agonist as luteal phase support in assisted reproduction technique cycles: results of a pilot study. Hum Reprod. 2006; 21(7): 1894–1900.
  6. Pirard C, Loumaye E, Laurent P, et al. Contribution to More Patient-Friendly ART Treatment: Efficacy of Continuous Low-Dose GnRH Agonist as the Only Luteal Support-Results of a Prospective, Randomized, Comparative Study. Int J Endocrinol. 2015; 2015: 727569.
  7. Mendoza-Tesarik R, Mendoza N, López CC, et al. GnRH agonist treatment of luteal phase deficiency in HCG-triggered IVF cycles: a matched case-control study. Reprod Biomed Online. 2019; 39(2): 225–230.
  8. Tesarik J, Hazout A, Mendoza-Tesarik R, et al. Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles. Hum Reprod. 2006; 21(10): 2572–2579.
  9. Isik AZ, Caglar GS, Sozen E, et al. Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study. Reprod Biomed Online. 2009; 19(4): 472–477.
  10. Kyrou D, Kolibianakis EM, Fatemi HM, et al. Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: a systematic review and meta-analysis. Hum Reprod Update. 2011; 17(6): 734–740.
  11. Inamdar DB, Majumdar A. Evaluation of the impact of gonadotropin-releasing hormone agonist as an adjuvant in luteal-phase support on IVF outcome. J Hum Reprod Sci. 2012; 5(3): 279–284.
  12. Qublan H, Qublah H, Amarin Z, et al. Luteal phase support with GnRH-a improves implantation and pregnancy rates in IVF cycles with endometrium of CrossRefPubMed
  • Ata B, Yakin K, Balaban B, et al. GnRH agonist protocol administration in the luteal phase in ICSI-ET cycles stimulated with the long GnRH agonist protocol: a randomized, controlled double blind study. Hum Reprod. 2008; 23(3): 668–673.
  • Maged AM, Nada AM, Abohamila F, et al. Delayed Start Versus Conventional GnRH Antagonist Protocol in Poor Responders Pretreated With Estradiol in Luteal Phase: A Randomized Controlled Trial. Reprod Sci. 2015; 22(12): 1627–1631.
  • Haas J, Bassil R, Samara N, et al. GnRH agonist and hCG (dual trigger) versus hCG trigger for final follicular maturation: a double-blinded, randomized controlled study. Hum Reprod. 2020; 35(7): 1648–1654.
  • Sloth A, Kjølhede M, Sarmon KG, et al. Effect of dual trigger on reproductive outcome in low responders: a systematic PRISMA review and meta-analysis. Gynecol Endocrinol. 2022; 38(3): 213–221.