Effect of Adding GnRH-a in Luteal Support of Fresh Embryo Transfer Cycles with GnRH Antagonist Protocol on Clinical Outcomes / 实用妇产科杂志

ABSTRACT

Objective:To compare the effect of luteal-phase support administration of gonadotrophin-releasing hormone agonist(GnRH-a)on the outcomes of fresh embryo transfer in GnRH antagonist cycles,and explore a more appropriate protocol of luteal-phase support.Methods:A retrospective analysis was performed on the infer-tility patients who receiving in vitro fertilization or intracytoplasmic sperm injection embryo transfer(IVF/ICSI-ET)in the Reproductive Medicine Center of our hospital from January 2018 to December 2021.Our study collected clini-cal data from 674 cycles of infertility patients undergoing fresh cycle transplantation using antagonist regimens.The patients were divided into the control group(n =348)and the observation group(n =326)according to if Gn-RH-a was added to the luteal phase.The patients in control group were given standard luteal support treatment,while the patients in observation group were given multiple-dose GnRH-a 0.1mg to standard luteal support treat-ment after egg retrieval.The general data,ovulation induction and clinical outcome were compared between the two groups.Results:Between the two groups of patients,there was no statistically significant difference in age,years of infertility,body mass index(BMI),basal follicle stimulating hormone(bFSH),days and total amount of gonadotropin(Gn),chorionic gonadotropin(HCG),luteinizing hormone(LH),estradiol(E2)and progesterone(P),the number of retrieved oocytes,MII oocytes,number of embryos,normal fertilization rate,moderate to se-vere ovarian hyperstimulation syndrome(OHSS)rate,abortion rate,live birth rate,multiple pregnancy rate,inci-dence of pregnancy complications,birth weight of offspring,preterm birth rate,and birth defect rate(P>0.05).The implantation rate and clinical pregnancy rate were significantly higher in the observation group compared with control group(P<0.05).Multivariate Logistic regression analysis indicated that age and number of transferred embryos could influence the clinical pregnancy rate(OR 0.958,95%CI 0.917-1.000;OR 1.857,95%CI 1.173-2.942).Conclusions:In fresh embryo transfer cycles with GnRH antagonist protocol,on the basis of conventional luteal support,multi-dose intermittent short-acting GnRH-a for luteal support can achieve a good clin-ical outcome,and may be a suitable luteal support scheme for GnRH antagonist protocol in fresh embryo transfer cycles.