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Du L, Song J, Fan W, Ye T, Kong H. Safety profiles of offspring born from early-follicular long-acting GnRH agonist protocol and daily mid-luteal GnRH agonist protocol: a retrospective study. BMC Pregnancy Childbirth 2024; 24:393. [PMID: 38807043 PMCID: PMC11134633 DOI: 10.1186/s12884-024-06589-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 05/15/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND The gonadotropin hormone-releasing hormone agonists (GnRH-a) have been widely used for controlled ovarian stimulation in assisted reproductive technology (ART). The early-follicular long-acting GnRH-a long protocol (EFL) and the luteal phase short-acting GnRH-a long protocol (LPS) are commonly used GnRH agonist protocols. We conducted a retrospective analysis to assess and compare the rates of congenital abnormalities and safety profiles in offspring born from the EFL and LPS protocols. METHODS We conducted a retrospective cohort study to analyze and compare neonatal data from patients who using EFL or LPS protocols at our center between January 1, 2014, and June 30, 2017. The study ultimately included 1810 neonates from 1401 cycles using the EFL protocol and 2700 neonates from 2129 cycles using the LPS protocol.The main outcome measures are gestational age at delivery, birth weight, and congenital anomaly rate.To assess the influence of various factors on congenital abnormalities, a random-effects logistic regression model was employed. RESULTS The EFL and LPS protocols led to similar congenital anomaly rates (1.64% vs. 2.35%, P = 0.149). No significant differences were found between the two groups regarding birth weight and its categories, newborn gender and congenital anomaly rate. The results of the multivariate logistic regression model indicated no association between congenital anomaly and BMI, duration of infertility, treatment protocol, fertilization method, or embryo transfer stage. Compared with singleton pregnancies, the probability of congenital defects in multiple pregnancies was 2.64 times higher (OR: 2.64, 95% CI: 1.72-4.05, P < 0.0001). Newborns with congenital defects were born with a lower gestational age compared with full-term pregnancies. CONCLUSION In conclusion, the EFL protocol is considered a safe option for ensuring offspring safety, comparable with the LPS protocol; however, multiple pregnancies represent an independent risk factor for congenital abnormalities. This approach can be widely adopted; however, prioritizing single embryo transfers is strongly recommended to minimize the potential risks associated with multiple pregnancies in offspring.
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Affiliation(s)
- Linqing Du
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Road, Zhengzhou, 450000, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianyuan Song
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Road, Zhengzhou, 450000, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenqian Fan
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Road, Zhengzhou, 450000, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tian Ye
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Road, Zhengzhou, 450000, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huijuan Kong
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, No.1, Jianshe Road, Zhengzhou, 450000, China.
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Kabodmehri R, Ghanami Gashti N, Raoufi A, Mehrafza M, Nikpouri Z, Hosseinzadeh E, Hosseini A. Pregnancy outcome in long- versus short-acting gonadotropin-releasing hormone agonist cycles in participants with normal ovarian reserve: An RCT. Int J Reprod Biomed 2023; 21:759-766. [PMID: 37969567 PMCID: PMC10643683 DOI: 10.18502/ijrm.v21i9.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/22/2023] [Accepted: 08/28/2023] [Indexed: 11/17/2023] Open
Abstract
Background There is no agreement on which of the 2 gonadotropin-releasing hormone (GnRH) agonist protocols are the most efficient, neither there is any consensus on which one yields a better clinical pregnancy percentage. Objective The present study aims to compare the effectiveness of reduced dosages of long- and short-acting GnRH agonists on pregnancy outcomes. Materials and Methods In this randomized controlled clinical trial, 400 women were randomly assigned to 2 groups (n = 200/group): the reduced dosage of long-acting GnRH agonist group (group 1, 1.25 mg Decapeptyl) and the short-acting GnRH agonist group (group 2, 0.5 mg/day Buserelin Acetate). The study was conducted at Mehr Medical Institute, Rasht, Iran between July 2019 and July 2020. Biochemical and clinical pregnancy were compared between groups. Results No significant differences were observed in the endometrial lining, the total number of retrieved and metaphase-II oocytes, progesterone, and serum estradiol levels on human chorionic gonadotropin day, fertilization rate, and top-quality embryos between the groups. The duration of induction (10.8 ± 1.7 vs. 10 ± 2.1, p < 0.001) and the total dosage of gonadotropins (2939.4 ± 945.9 vs. 2441 ± 1247.1, p < 0.001) were significantly greater in group 2 than in group 1. No significant differences were observed between the 2 groups in terms of implantation rate, chemical pregnancy rate, and clinical pregnancy rate. A higher percentage of ovarian hyperstimulation syndrome was observed in group 2 (p = 0.005). Conclusion Due to a lower percentage of ovarian hyperstimulation syndrome in group 1 and similar assisted reproductive technology outcomes in both groups, the long protocol was found to be superior to the short protocol.
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Affiliation(s)
- Roya Kabodmehri
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Nasrin Ghanami Gashti
- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Azadeh Raoufi
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Marzieh Mehrafza
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Nikpouri
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Elmira Hosseinzadeh
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ahmad Hosseini
- Mehr Fertility Research Center, Guilan University of Medical Sciences, Rasht, Iran
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Zhang Y, Zhao W, Han Y, Chen X, Xu S, Hu Y, Diao H, Zhang C. The follicular-phase depot GnRH agonist protocol results in a higher live birth rate without discernible differences in luteal function and child health versus the daily mid-luteal GnRH agonist protocol: a single-centre, retrospective, propensity score matched cohort study. Reprod Biol Endocrinol 2022; 20:140. [PMID: 36123706 PMCID: PMC9483542 DOI: 10.1186/s12958-022-01014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 09/10/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The gonadotropin-releasing hormone agonist (GnRH-a) has been used in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles for a long time. This paper evaluates the efficacy and safety of two commonly used protocols (follicular-phase depot GnRH-a protocol and daily mid-luteal long GnRH-a protocol) in normal responders undergoing IVF/ICSI using propensity score matching (PSM) analysis. METHODS A total of 6,816 infertile women treated within the period from January 2016 to September 2020 were stratified into cohorts. A total of 2,851 patients received the long-acting group (depot GnRH-a protocol), and 1,193 used the short-acting group (long GnRH-a protocol) after the data-selection process. PSM was utilized for sampling by up to 1:1 nearest neighbour matching to adjust the numerical difference and balance the confounders between groups. The primary outcome was the live birth rate (LBR). Multivariable logistic analysis was used to evaluate the difference between these two protocols in relation to the LBR. RESULT(S) In this study, 1:1 propensity score matching was performed to create a perfect match of 964 patients in each group. After matching, the blastocyst formation rates, oestradiol (E2) value on Day hCG + 9, progesterone (P) value on Day hCG + 9, implantation rates, clinical pregnancy rates, and LBR were more favourable in the depot GnRH-a protocol than in the long GnRH-a protocol (P < 0.05). However, the moderate or severe OHSS rates were higher in the depot group than in the long group (P < 0.001). There were no significant differences in endometrial thickness, luteal support medication, early pregnancy loss rates, mid- and late-term pregnancy loss rates, or foetal malformation rates between the two protocols. CONCLUSION(S) Compared with the daily short-acting GnRH agonist protocol, the follicular-phase depot GnRH-a protocol might improve LBRs in normogonadotropic women without discernible differences in luteal function and child health.
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Affiliation(s)
- Ying Zhang
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Wenxian Zhao
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
| | - Yifan Han
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Xin Chen
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Shaoyuan Xu
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Yueyue Hu
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Honglu Diao
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Changjun Zhang
- grid.443573.20000 0004 1799 2448Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, People’s Republic of China
- Hubei Clinical Research Center for Reproductive Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Engineering College, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Biomedical Research Institute, Hubei University of Medicine, Shiyan, People’s Republic of China
- grid.443573.20000 0004 1799 2448Hubei Key Laboratory of Embryonic Stem Cell Research, Hubei University of Medicine, Shiyan, People’s Republic of China
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Ying Y, Lu X, Zhang H, Arhin SK, Hou X, Wang Z, Wu H, Lu J, Tang Y. Clinical and perinatal outcomes of fresh single-blastocyst-transfer cycles under an early follicular phase prolonged protocol according to day of trigger estradiol levels. PeerJ 2021; 9:e11785. [PMID: 34395072 PMCID: PMC8320517 DOI: 10.7717/peerj.11785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 06/24/2021] [Indexed: 11/30/2022] Open
Abstract
Backgroud This study’s objectives were to compare the clinical, perinatal, and obstetrical outcomes of patients with different estradiol (E2) levels in fresh single-blastocyst-transfer (SBT) cycles under an early follicular phase prolonged regimen on the day of trigger. Methods We recruited patients in fresh SBT cycles (n = 771) undergoing early follicular phase prolonged protocols with β-hCG values above 10 IU/L between June 2016 and December 2018. Patients who met the inclusion and exclusion criteria were divided into four groups according to their serum E2 level percentages on the day of trigger: <25th, 25th–50th, 51st–75th, and >75th percentile groups. Results Although the rates of clinical pregnancy (85.57% (166/194)), embryo implantation 86.60% (168/194), ongoing pregnancy (71.13% (138/194)), and live birth (71.13% (138/194)) were lowest in the >75th percentile group, we did not observe any significant differences (all P > 0.05). We used this information to predict the rate of severe ovarian hyperstimulation syndrome (OHSS) area under the curve (AUC) = 72.39%, P = 0.029, cut off value of E2 = 2,893 pg/ml with the 75% sensitivity and 70% specificity. The 51st–75th percentile group had the highest rates of low birth weight infants (11.73% (19/162), P = 0.0408), premature delivery (11.43% (20/175), P = 0.0269), admission to the neonatal intensive care unit (NICU) (10.49% (17/162), P = 0.0029), twin pregnancies (8.57% (15/175), P = 0.0047), and monochorionic diamniotic pregnancies (8.57% (15/175); P = 0.001). We did not observe statistical differences in obstetrics complications, including gestational diabetes mellitus (GDM), gestational hypertension, placenta previa, premature rupture of membranes (PROM), and preterm premature rupture of membranes (PPROM). Conclusion We concluded that serum E2 levels on the day of trigger were not good predictors of live birth rate or perinatal and obstetrical outcomes. However, we found that high E2 levels may not be conducive to persistent pregnancies. The E2 level on the day of trigger can still be used to predict the incidence of early onset severe OHSS in the fresh SBT cycle.
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Affiliation(s)
- Yingfen Ying
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaosheng Lu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huina Zhang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Samuel Kofi Arhin
- School of Allied Health Sciences, University of Cape Coast, PMB, Cape Coast, Ghana
| | - Xiaohong Hou
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zefan Wang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Han Wu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jieqiang Lu
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yunbing Tang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Chen M, Luo L, Wang Q, Gao J, Chen Y, Zhang Y, Zhou C. Impact of Gonadotropin-Releasing Hormone Agonist Pre-treatment on the Cumulative Live Birth Rate in Infertile Women With Adenomyosis Treated With IVF/ICSI: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2020; 11:318. [PMID: 32547490 PMCID: PMC7273842 DOI: 10.3389/fendo.2020.00318] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/24/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Although pre-treatment with a GnRH agonist can reduce the size of adenomyosis lesions, the supra-physiological hormone level induced by controlled ovarian hyperstimulation (COH) may negate the usefulness of the GnRH agonist in patients with adenomyosis lesions, leading to continued poor outcomes in fresh embryo transfer cycles during in vitro fertilization (IVF). It is unclear whether GnRH agonist pre-treatment before starting the long GnRH agonist protocol for IVF/ICSI (intracytoplasmic sperm injection) can improve cumulative live birth rate (CLBR) of infertile women with adenomyosis. Method: In this retrospective cohort study, a total of 374 patients diagnosed as adenomyosis (477 cycles) underwent IVF/ICSI with long GnRH agonist protocol with or without GnRH agonist pre-treatment between January 2009 and June 2018. Logistic regression was used to assess the association between GnRH agonist pre-treatment and pregnancy outcome after adjusting for confounding factors. Results: The live birth rate in fresh embryo transfer cycles was higher in the non-pre-treatment group than in the GnRH agonist pre-treatment group (37.7 vs. 21.2%, P = 0.028); the adjusted odds ratio (OR) for the long agonist protocol without pre-treatment was 1.966 (95% CI: 0.9-4.296, P = 0.09). The CLBR was higher in the non-pre-treatment group than in the GnRH agonist pre-treatment group (40.50 vs. 27.90%, P = 0.019); the adjusted OR for the long agonist protocol without pre-treatment was 1.361 (95% CI: 0.802-2.309, P = 0.254). Conclusion: Our results indicated that GnRH agonist pre-treatment before starting the long GnRH agonist protocol does not improve the live birth rate in fresh embryo transfer cycles or CLBR in infertile women with adenomyosis after IVF/ICSI treatment when compared to that in non-pre-treated patients. A subsequent prospective randomized controlled study is needed to confirm these results.
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Affiliation(s)
- Minghui Chen
- Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lu Luo
- Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Qiong Wang
- Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Qiong Wang
| | - Jun Gao
- Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuqing Chen
- Department of Gynecology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yingying Zhang
- Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Canquan Zhou
- Reproductive Medicine Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Canquan Zhou
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Ying Y, Yang T, Zhang H, Liu C, Zhao J. Prolonged pituitary down-regulation with full-dose of gonadotropin-releasing hormone agonist in different menstrual cycles: a retrospective cohort study. PeerJ 2019; 7:e6837. [PMID: 31106057 PMCID: PMC6497042 DOI: 10.7717/peerj.6837] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 03/23/2019] [Indexed: 01/31/2023] Open
Abstract
Background The efficiency of prolonged down-regulation caused by a full-dose of gonadotropin-releasing hormone agonist (GnRH-a) injected during different menstrual phases has not yet been researched. Our goal was to evaluate the effects of GnRH-a, which was used in different phases of the menstrual cycle in patients undergoing in vitro fertilization and embryo transfer. Methods This was a retrospective cohort study. A total of 320 patients received a prolonged pituitary down-regulated full-dose (3.75 mg) of triptorelin in the early follicular phase, and 160 patients received the same full-dose of triptorelin during the mid-luteal phase. Clinical and laboratory outcomes were compared between the two groups. Results The basic characteristics of the two groups were comparable. The mean number of retrieved oocytes, fertilized oocytes, cleavage oocytes and good quality embryos were comparable between the two groups. Although there was a higher antral follicle count, cyst formation rate, fertilization rate and cleavage rate in the follicular phase group, no statistically significant effects were seen on implantation rate (41.15% vs. 45.91%), clinical pregnancy rate (60.38% vs. 61.36%), ongoing pregnancy rate (57.74% vs. 57.58%), live birth rate (56.23% vs. 57.58%) or early abortion rate (2.64% vs. 3.79%) per fresh transfer cycle. Moreover, severe ovarian hyperstimulation syndrome rates at the early stage (1.89% vs. 2.27%) were low in both groups. Conclusions Prolonged pituitary down-regulation achieved by utilizing a full-dose of GnRH-a administrated in either phase of the menstrual cycle can have a positive effect on ongoing pregnancy rate and live-birth rate per fresh embryo transfer cycle. Ovarian cyst formation rate was higher in the follicular phase group, but this did not have any adverse impact on clinical results.
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Affiliation(s)
- Yingfen Ying
- Reproductive Medical Center, Department of OB & GYN, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Tanchu Yang
- Reproductive Medical Center, Department of OB & GYN, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Huina Zhang
- Reproductive Medical Center, Department of OB & GYN, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chang Liu
- Reproductive Medical Center, Department of OB & GYN, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Junzhao Zhao
- Reproductive Medical Center, Department of OB & GYN, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Azumaguchi A, Henmi H, Ohnishi H, Endo T, Saito T. Role of dilatation and curettage performed for spontaneous or induced abortion in the etiology of endometrial thinning. J Obstet Gynaecol Res 2017; 43:523-529. [DOI: 10.1111/jog.13254] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 10/13/2016] [Accepted: 11/08/2016] [Indexed: 01/06/2023]
Affiliation(s)
| | - Hirofumi Henmi
- Department of Gynecology and Reproductive Endocrinology; KKR Sapporo Medical Center, Tonan Hospital; Sapporo Japan
| | - Hirofumi Ohnishi
- Department of Public Health; Sapporo Medical University; Sapporo Japan
| | - Toshiaki Endo
- Department of Obstetrics and Gynecology; Sapporo Medical University; Sapporo Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology; Sapporo Medical University; Sapporo Japan
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