The pregnancy results were not affected from the administration day of Depot GnRH agonists in artificial cycle frozen-thawed embryo transfers

Year 2023, Volume: 4 Issue: 2, 89 - 93, 27.03.2023

Mehmet Ağar , Asena Ayar Madenli , Nur Dokuzeylül Güngör , Şebnem Alanya Tosun

https://doi.org/10.47582/jompac.1219205

Abstract

Aim: In frozen-thawed embryo transfers (FET), Gonadotropin-Releasing Hormone (GnRH) agonists have recently been used to improve implantation results. It is preferred to administer it in the luteal phase of the previous cycle. The objective was to compare the effects of different administration days of depot GnRH agonists on implantation and pregnancy rates in the artificial cycle of FET.
Material and Methods: A retrospective case-control study was conducted in an in vitro fertilization (IVF) center in a university hospital including all women starting an artificial cycle of FET. One thousand two hundred and twenty-seven (n:1227) FET cycles were scanned from the files from October 2014 to December 2021. Depot agonists (Lucrin depot 3.75 mg sc Abbott USA.-leuprolide acetate) were used in 219 patients with endometriosis. In 58 patients it was administered at day 21 on the previous cycle (Group 1) and on 161 patients it was administered at day 2 of the same cycle (Group 2).
Results: This study showed no statistically significant difference between the two groups in laboratory parameters and endometrial thickness (p>0.05). There was not a statistically significant association between the abort rate and transfer day (p>0.05). There was not a statistically significant association between the pregnancy results and transfer day (p>0.05). The ongoing pregnancy rate (OPR) rate was relatively high in the second group compared to the twenty-first day of the previous cycle (87/161(54%) vs. 30/58 (51.7%)). The biochemical pregnancy was relatively high in the second-day group compared to the twenty-first day of the previous cycle (62/161(38.5%) vs. 21/58 (36.2%)). The abort rate was relatively high in the twenty-first-day group compared to the second-day of the cycle (25/87(28.75%) vs. 9/30(30%)).
Conclusion: In conclusion, the impacts of various administration days of depot Gonadotropin-releasing hormone (GnRH) agonists on implantation and pregnancy rates were not statistically significant.

Keywords

Assisted reproduction technology; Frozen-thawed embryo transfer cycle; GnRH agonists; Implantation, Assisted reproduction technology, FET cycle, GnRH agonist, implantation

The pregnancy results were not affected from the administration day of Depot GnRH agonists in artificial cycle frozen-thawed embryo transfers

Abstract

Aim: In frozen-thawed embryo transfers (FET), Gonadotropin-Releasing Hormone (GnRH) agonists have recently been used to improve implantation results. It is preferred to administer it in the luteal phase of the previous cycle. The objective was to compare the effects of different administration days of depot GnRH agonists on implantation and pregnancy rates in the artificial cycle of FET.
Material and Method: A retrospective case-control study was conducted in an in vitro fertilization (IVF) center in a university hospital, including all women starting an artificial cycle of FET. One thousand two hundred and twenty-seven (n:1227) FET cycles were scanned from the files from October 2014 to December 2021. Depot agonists (Lucrin depot 3.75 mg sc Abbott USA.-leuprolide acetate) were used in 219 patients with endometriosis. In 58 patients, it was administered on day 21 of the previous cycle (Group 1), and in 161 patients, it was administered on day 2 of the same cycle (Group 2).
Results: This study showed no statistically significant difference between the two groups in laboratory parameters and endometrial thickness (p>0.05). There was no statistically significant association between the abort rate and transfer day (p>0.05). There was no statistically significant association between the pregnancy results and transfer day (p>0.05). The ongoing pregnancy rate (OPR) rate was relatively high in the second group compared to the twenty-first day of the previous cycle (87/161(54%) vs. 30/58 (51.7%)). The biochemical pregnancy was relatively high in the second-day group compared to the twenty-first day of the previous cycle (62/161(38.5%) vs. 21/58 (36.2%)). The abort rate was relatively high in the twenty-first-day group compared to the second day of the cycle (25/87(28.75%) vs. 9/30(30%)).
Conclusion: In conclusion, the impacts of various administration days of depot Gonadotropin-releasing hormone (GnRH) agonists on implantation and pregnancy rates were not statistically significant.

Keywords

Assisted reproduction technology, FET cycle, GnRH agonist, implantation

References

• Gulzar U, Randhawa RK, Chaudhary P. Infertility as a burden-women as victim. Infertility 2021; 7.
• Akintayo AA, Aduloju OP, Dada MU, Abiodun-Ojo OA, Oluwole LO, Ade-Ojo IP. Comparison of self-esteem and depression among fertile and infertile women in a low resource setting. J Obstet Gynaecol 2022; 42: 1198-203.
• Güngör ND, Gürbüz T, Yurci A. Does depot analog suppression have positive effects on all other frozen-thawed embryo transfer cycles in addition to endometriosis. Ulutas Med J 2021; 7: 22-30.
• He Y, Zheng H, Du H, et al. Delayed frozen embryo transfer failed to improve live birth rate and neonatal outcomes in patients requiring whole embryo freezing. Reprod Biol Endocrinol 2020; 18: 1.
• Wu HM, Chen LH, Hsu LT, Lai CH. Immune tolerance of embryo implantation and pregnancy: the role of human decidual stromal cell- and embryonic-derived extracellular vesicles. Int J Mol Sci 2022; 23: 13382.
• Neykova K, Tosto V, Giardina I, Tsibizova V, Vakrilov G. Endometrial receptivity and pregnancy outcome. J Matern Fetal Neonatal Med 2022; 35: 2591-2605.
• Lensen S, Lantsberg D, Gardner DK, Sophian AD, Wandafiana N, Kamath MS. The role of timing in frozen embryo transfer. Fertil Steril 2022; 118: 832-8.
• Liebermann J, Tucker MJ. Comparison of vitrification and conventional cryopreservation of day 5 and day 6 blastocysts during clinical application. Fertil Steril 2006; 86: 20-6.
• Chatzimeletiou K, Petrogiannis N, Sioga A, et al. The human embryo following biopsy on day 5 versus day 3: viability, ultrastructure and spindle/chromosome configurations. Reprod Biomed Online 2022; 45: 219-33.
• Xu H, Qiu S, Chen X, Zhu S, Sun Y, Zheng B. D6 blastocyst transfer on day 6 in frozen-thawed cycles should be avoided: a retrospective cohort study. BMC Pregnancy Childbirth 2020; 20: 519.
• Devroey P, Polyzos NP, Blockeel C. An OHSS-Free Clinic by segmentation of IVF treatment. Hum Reprod 2011; 26: 2593-7.
• Roque M, Haahr T, Geber S, Esteves SC, Humaidan P. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes. Hum Reprod Update 2019; 25: 2-14.
• Roque M. Freeze-all policy: is it time for that? J Assist Reprod Genet 2015; 32: 171-6.
• Gao DD, Li L, Zhang Y, Wang XX, Song JY, Sun ZG. Is Human chorionic gonadotropin trigger beneficial for natural cycle frozen-thawed embryo transfer? Front Med (Lausanne). 2021; 8: 691428.
• Rebar R. Evaluation of amenorrhea, anovulation, and abnormal bleeding. Endotext [Internet]. 2018.
• Wang Y, Hu WH, Wan Q, et al. Effect of artificial cycle with or without GnRH-a pretreatment on pregnancy and neonatal outcomes in women with PCOS after frozen embryo transfer: a propensity score matching study. Reprod Biol Endocrinol 2022; 20: 56.
• 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: 319-26.
• Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009; 41: 1149-60.
• Zhang T, Li Z, Ren X, Huang B, Zhu G, Yang W, Jin L. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: a retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine (Baltimore) 2018; 97: e9689.
• Olgan S, Dirican EK, Sakinci M, et al. Endometrial compaction does not predict the reproductive outcome after vitrified-warmed embryo transfer: a prospective cohort study. Reprod Biomed Online 2022; 45: 81-7.
• Liu X, Qu P, Bai H, Shi W, Shi J. Endometrial thickness as a predictor of ectopic pregnancy in 1125 in vitro fertilization-embryo transfer cycles: a matched case-control study. Arch Gynecol Obstet 2019; 300: 1797-803.
• Roelens C, Blockeel C. Impact of different endometrial preparation protocols before frozen embryo transfer on pregnancy outcomes: a review. Fertil Steril 2022; 118: 820-7.
• Lou L, Xu Y, Lv M, et al. Comparison of different endometrial preparation protocols on frozen embryo transfer pregnancy outcome in patients with normal ovulation. Reprod Biomed Online 2022; 45: 1182-7.
• Bu Z, Yang X, Song L, Kang B, Sun Y. The impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst. Reprod Biol Endocrinol 2019; 17: 99.
• Ye J, Zhang J, Gao H, et al. Effect of endometrial thickness change in response to progesterone administration on pregnancy outcomes in frozen-thawed embryo transfer: analysis of 4465 cycles. Front Endocrinol (Lausanne) 2020; 11: 546232.
• Racca A. The Future of endometrial preparation: challenges and opportunities. Reproductive Health 2021.
• Glujovsky D, Pesce R, Sueldo C, Quinteiro Retamar AM, Hart RJ, Ciapponi A. Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. Cochrane Database Syst Rev 2020; 10: CD006359..
• Caspi E, Ron-El R, Golan A, et al. Results of in vitro fertilization and embryo transfer by combined long-acting gonadotropin-releasing hormone analog D-Trp-6-luteinizing hormone-releasing hormone and gonadotropins. Fertil Steril 1989; 51: 95-9.
• Zorn JR, Boyer P, Guichard A. Never on a Sunday: programming for IVF-ET and GIFT. Lancet 1987; 1: 385-6.