Skip to main content
SpringerLink
Log in

Pituitary suppression before frozen embryo transfer is beneficial for patients suffering from idiopathic repeated implantation failure

  • Published:
Journal of Huazhong University of Science and Technology [Medical Sciences] Aims and scope Submit manuscript

Summary

Long-term gonadotropin-releasing hormone agonist (GnRHa) administration before in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in infertile women with endometriosis or adenomyosis significantly enhanced the chances of pregnancy in both fresh and frozen embryo transfer cycles. We hypothesized that long-term GnRHa treatment might also be beneficial for the idiopathic repeated implantation failure (RIF) patients. In the 21 patients receiving GnRHa and hormone replacement therapy (G-HRT) protocols for frozen embryo transfer, their data were compared with those of the 56 of frozen/fresh cycles they had previously undergone (previous protocols). Comparison showed that the finial results were significantly better with G-HRT protocols than with their previous protocols, with pregnancy rate, clinical pregnancy rate, implantation rate and on-going pregnancy rate being 70%, 60%, 40% and 38% respectively with G-HRT protocols, against 17%, 11%, 6.3% and 5% with previous protocols. The results showed that hormonally controlled endometrial preparation with prior GnRHa suppression could be used for patients who had experienced repeated failures of IVF treatment despite having morphologically optimal embryos, and the treatment may help increase the receptivity of the endometrium in these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Raziel A, Friedler S, Schachter M, et al. Increased frequency of female partner chromosomal abnormalities in patients with high-order implantation failure after in vitro fertilization. Fertil Steril, 2002,78(3):515–519

    Article  PubMed  Google Scholar 

  2. Rubio C, Gil-Salom M, Simon C, et al. Incidence of sperm chromosomal abnormalities in a risk population: relationship with sperm quality and ICSI outcome. Hum Reprod, 2001,16(10):2084–2092

    Article  CAS  PubMed  Google Scholar 

  3. Voullaire L, Wilton L, McBain J, et al. Chromosome abnormalities identified by comparative genomic hybridization in embryos from women with repeated implantation failure. Mol Hum Reprod, 2002,8(11):1035–1041

    Article  CAS  PubMed  Google Scholar 

  4. Surrey ES. Impact of intramural leiomyomata on in-vitro fertilization-embryo transfer cycle outcome. Curr Opin Obstet Gynecol, 2003,15(3):239–242

    Article  PubMed  Google Scholar 

  5. Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with recurrent IVF failure. Reprod Biomed Online, 2004,8(5): 590–594

    Article  PubMed  Google Scholar 

  6. Costello MF, Lindsay K, McNally G. The effect of adenomyosis on in vitro fertilisation and intra-cytoplasmic sperm injection treatment outcome. Eur J Obstet Gynecol Reprod Biol, 2011,158(2):229–234

    Article  PubMed  Google Scholar 

  7. Hatasaka H. New perspectives for unexplained infertility. Clin Obstet Gynecol, 2011,54(4):727–733

    Article  PubMed  Google Scholar 

  8. Isaksson R, Tiitinen A. Present concept of unexplained infertility. Gynecol Endocrinol, 2004,18(5):278–290

    Article  CAS  PubMed  Google Scholar 

  9. Tan BK, Vandekerckhove P, Kennedy R, et al. Investigation and current management of recurrent IVF treatment failure in the UK. BJOG, 2005,112(6):773–780

    Article  PubMed  Google Scholar 

  10. Coughlan C, Ledger W, Wang Q, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online, 2014,28(1):14–38

    Article  CAS  PubMed  Google Scholar 

  11. Cohen J, DeVane GW, Elsner CW, et al. Cryopreserved zygotes and embryos and endocrinologic factors in the replacement cycle. Fertil Steril, 1988,50(1):61–67

    CAS  PubMed  Google Scholar 

  12. Oehninger S, Mayer J, Muasher S. Impact of different clinical variables on pregnancy outcome following embryo cryopreservation. Mol Cell Endocrinol, 2000,169 (1–2):73–77

    Article  CAS  PubMed  Google Scholar 

  13. de Ziegler D, Cornel C, Bergeron C, et al. Controlled preparation of the endometrium with exogenous estradiol and progesterone in women having functioning ovaries. Fertil Steril, 1991,56(5):851–855

    PubMed  Google Scholar 

  14. Queenan Jr, Veeck LL, Seltman HJ, et al. Transfer of cryopreserved-thawed pre-embryos in a natural cycle or a programmed cycle with exogenous hormonal replacement yields similar pregnancy results. Fertil Steril, 1994,62(3): 545–550

    PubMed  Google Scholar 

  15. Lin J, Sun C, Zheng H. Gonadotropin-releasing hormone agonists and laparoscopy in the treatment of adenomyosis with infertility. Chin Med J (Engl), 2000,113(5):442–445

    CAS  Google Scholar 

  16. Silva PD, Perkins HE, Schauberger CW. Live birth after treatment of severe adenomyosis with a gonadotropin-releasing hormone agonist. Fertil Steril, 1994,61(1): 171–172

    CAS  PubMed  Google Scholar 

  17. Surrey ES, Silverberg KM, Surrey MW, et al. Effect of prolonged gonadotropin-releasing hormone agonist therapy on the outcome of in vitro fertilization-embryo transfer in patients with endometriosis. Fertil Steril, 2002,78(4): 699–704

    Article  PubMed  Google Scholar 

  18. Huang FJ, Kung FT, Chang SY, et al. Effects of short-course buserelin therapy on adenomyosis. A report of two cases. J Reprod Med, 1999,44(8):741–744

    CAS  PubMed  Google Scholar 

  19. Devlieger R, D'Hooghe T, Timmerman D. Uterine adenomyosis in the infertility clinic. Hum Reprod Update, 2003,9(2):139–147

    Article  PubMed  Google Scholar 

  20. Niu Z, Chen Q, Sun Y, et al. Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis. Gynecol Endocrinol, 2013,29(12):1026–1030

    Article  CAS  PubMed  Google Scholar 

  21. Simon A, Hurwitz A, Zentner BS, et al. Transfer of frozen-thawed embryos in artificially prepared cycles with and without prior gonadotrophin-releasing hormone agonist suppression: a prospective randomized study. Hum Reprod, 1998,13(10):2712–2717

    Article  CAS  PubMed  Google Scholar 

  22. Tremellen K, Russell P. Adenomyosis is a potential cause of recurrent implantation failure during IVF treatment. Aust N Z J Obstet Gynaecol, 2011,51(3):280–283

    Article  PubMed  Google Scholar 

  23. Barnhart K, Dunsmoor-Su R, Coutifaris C. Effect of endometriosis on in vitro fertilization. Fertil Steril, 2002,77 (6):1148–1155

    Article  PubMed  Google Scholar 

  24. Kuivasaari P, Hippelainen M, Anttila M, et al. Effect of endometriosis on IVF/ICSI outcome: stage III/IV endometriosis worsens cumulative pregnancy and live-born rates. Hum Reprod, 2005,20(11):3130–3135

    Article  PubMed  Google Scholar 

  25. Kyama CM, Debrock S, Mwenda JM, et al. Potential involvement of the immune system in the development of endometriosis. Reprod Biol Endocrinol, 2003,Dec(1):123

    Google Scholar 

  26. Kissler S, Zangos S, Kohl J, et al. Duration of dysmenorrhoea and extent of adenomyosis visualised by magnetic resonance imaging. Eur J Obstet Gynecol Reprod Biol, 2008,137(2):204–209

    Article  CAS  PubMed  Google Scholar 

  27. Sallam HN, Garcia-Velasco JA, Dias S, et al. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis. Cochrane Database Syst Rev, 2006:CD004635

    Google Scholar 

  28. Sharpe-Timms KL, Keisler LW, McIntush EW, et al. Tissue inhibitor of metalloproteinase-1 concentrations are attenuated in peritoneal fluid and sera of women with endometriosis and restored in sera by gonadotropin-releasing hormone agonist therapy. Fertil Steril, 1998,69(6): 1128–1134

    Article  CAS  PubMed  Google Scholar 

  29. Ferrero S, Gillott DJ, Remorgida V, et al. Proteomic analysis of peritoneal fluid in fertile and infertile women with endometriosis. J Reprod Med, 2009,54(1):32–40

    CAS  PubMed  Google Scholar 

  30. Ferrero S, Gillott DJ, Remorgida V, et al. GnRH analogue remarkably down-regulates inflammatory proteins in peritoneal fluid proteome of women with endometriosis. J Reprod Med, 2009,54(4):223–231

    CAS  PubMed  Google Scholar 

  31. Wang J, Zhou F, Dong M, et al. Prolonged gonadotropin-releasing hormone agonist therapy reduced expression of nitric oxide synthase in the endometrium of women with endometriosis and infertility. Fertil Steril, 2006,85(4): 1037–1044

    Article  CAS  PubMed  Google Scholar 

  32. Lessey BA. Medical management of endometriosis and infertility. Fertil Steril, 2000,73(6):1089–1096

    Article  CAS  PubMed  Google Scholar 

  33. Ruan HC, Zhu XM, Luo Q, et al. Ovarian stimulation with GnRH agonist, but not GnRH antagonist, partially restores the expression of endometrial integrin beta3 and leukaemia-inhibitory factor and improves uterine receptivity in mice. Hum Reprod, 2006,21(10):2521–2529

    Article  CAS  PubMed  Google Scholar 

  34. Kdous M, Chaker A, Bouyahia M, et al. Increased risk of early pregnancy loss and lower live birth rate with GNRH antagonist vs. long GNRH agonist protocol in PCOS women undergoing controlled ovarian hyperstimulation. Tunis Med, 2009,87(12):834–842

    PubMed  Google Scholar 

  35. Kwak-Kim JY, Chung-Bang HS, Ng SC, et al. Increased T helper 1 cytokine responses by circulating T cells are present in women with recurrent pregnancy losses and in infertile women with multiple implantation failures after IVF. Hum Reprod, 2003,18(4):767–773

    Article  CAS  PubMed  Google Scholar 

  36. Younis A, Hawkins K, Mahini H, et al. Serum tumor necrosis factor-alpha, interleukin-6, monocyte chemotactic protein-1 and paraoxonase-1 profiles in women with endometriosis, PCOS, or unexplained infertility. J Assist Reprod Genet, 2014,31(11):1445–1451

    Article  PubMed Central  PubMed  Google Scholar 

  37. Ledee-Bataille N, Bonnet-Chea K, Hosny G, et al. Role of the endometrial tripod interleukin-18,-15, and-12 in inadequate uterine receptivity in patients with a history of repeated in vitro fertilization-embryo transfer failure. Fertil Steril, 2005,83(3):598–605

    Article  CAS  PubMed  Google Scholar 

  38. van Gestel I, MM IJ, Hoogland HJ, et al. Endometrial wave-like activity in the non-pregnant uterus. Hum Reprod Update, 2003,9(2):131–138

    Article  PubMed  Google Scholar 

  39. Urman B, Ata B, Yakin K, et al. Luteal phase empirical low molecular weight heparin administration in patients with failed ICSI embryo transfer cycles: a randomized open-labeled pilot trial. Hum Reprod, 2009,24(7): 1640–1647

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Reproductive Medicine Centre, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510060, China

    Xing Yang  (杨 星), Rui Huang  (黄 睿), Yan-fang Wang  (王艳芳) & Xiao-yan Liang  (梁晓燕)

Authors
  1. Xing Yang  (杨 星)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rui Huang  (黄 睿)
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yan-fang Wang  (王艳芳)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xiao-yan Liang  (梁晓燕)
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Xiao-yan Liang  (梁晓燕).

Additional information

This project was supported by grants from the National Natural Science Foundation of China (No. 81100401 and No. 81470063), Guangdong Natural Science Foundation of China (No. 2014A030313129), and the Doctoral Fund of the Ministry of Education of China (No. 20110171120096).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, X., Huang, R., Wang, Yf. et al. Pituitary suppression before frozen embryo transfer is beneficial for patients suffering from idiopathic repeated implantation failure. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 36, 127–131 (2016). https://doi.org/10.1007/s11596-016-1554-2

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-016-1554-2

Key words

Search

Navigation