Skip to main content
SpringerLink
Log in

Artificial Cycle with or without a Depot Gonadotropin-releasing Hormone Agonist for Frozen-thawed Embryo Transfer: An Assessment of Infertility Type that Is Most Suitable

  • Published:
Current Medical Science Aims and scope Submit manuscript

Summary

The clinical outcomes of five groups of infertility patients receiving frozen-thawed, cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed. A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed, cleavage-stage embryo transfers from January 1, 2012 to June 31, 2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region. Based on the infertility etiologies of the patients, the 1003 cycles were divided into five groups: tubal infertility, polycystic ovary syndrome (PCOS), endometriosis, male infertility, and unexplained infertility. The main outcome was the live birth rate. Two groups were set up based on the intervention: group A was given a GnRH agonist with exogenous estrogen and progesterone, and group B (control group) was given exogenous estrogen and progesterone only. The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B. The live birth rates in groups A and B were 41.67% and 29.29%, respectively (P<0.05). The live birth rates in patients with PCOS in groups A and B were 56.25% and 30.61%,respectively (P<0.05). The clinical pregnancy, implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B. The ectopic pregnancy rate was significantly lower in group A than in group B. We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist cotreatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer. The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested, especially for women with PCOS.

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. Roque M, Lattes ?, Serra S, et al. Fresh embryo transfer versus frozen embryo transfer in in vitro fertilization cycles: a systematic review and metaanalysis. Fertil Steril, 2013, 99(1):156–162

    Article  PubMed  Google Scholar 

  2. Weinerman R, Mainigi M. Why we should transfer frozen instead of fresh embryos: the translational rationale. Fertil Steril, 2014, 02(1):10–18

    Google Scholar 

  3. Devroey P, Polyzos NP, Blockeel C. An OHSSFree Clinic by segmentation of IVF treatment. Hum Reprod, 2011, 26(10):2593–2597

    Article  PubMed  Google Scholar 

  4. Roque M. Freeze-all policy: is it time for that? J Assist Reprod Genet, 2015, 32(2):171–176

    Article  PubMed  Google Scholar 

  5. Shapiro BS, Daneshmand ST, Gamer FC, et al. Freeze-all at the blastocyst or bipronuclear stage: a randomized clinical trial. Fertil Steril, 2015, 104(5):1138–1144

    Article  PubMed  Google Scholar 

  6. Glujovsky D, Pesce R, Fiszbajn G, et al. Endometrial preparation for women undergoing embryo transfer with frozen embryos or embryos derived from donor oocytes. Cochrane Database Syst Rev, 2010, 1:CD006359

    Google Scholar 

  7. Groenewoud ER, Cantineau AE, Köllen BJ, et al. What is the optimal means of preparing the endometrium in frozen-thawed embryo transfer cycles? A systematic review and meta-analysis. Hum Reprod Update, 2013, 9(5):458–470

    Google Scholar 

  8. Ma WG, Song H, Das SK, et al. Estrogen is a critical determinant that specifies the duration of the window of uterine receptivity for implantation. Proc Natl Acad Sei, 2003, 4, 100(5):2963–2968

    Article  CAS  Google Scholar 

  9. Raga F, Casan EM, Kruessel JS, et al. Quantitative gonadotropin-releasing hormone gene expression and immunohistochemical localization in human endometrium throughout the menstrual cycle. Biol Reprod, 1998, 59(3):661–669

    Article  PubMed  CAS  Google Scholar 

  10. Khan KN, Kitajima M, Hiraki K, et al Cell proliferation effect of GnRH agonist on pathological lesions of women with endometriosis, adenomyosis and uterine myoma. Hum Repród, 2010, 25:2878–2890

    Article  PubMed  CAS  Google Scholar 

  11. Muasher SJ, Kruithoff C, Simonetti S, et al. Controlled preparation of the endometrium with exogenous steroids for the transfer of frozen-thawed pre-embryos in patients with anovulatory or irregular cycles. Hum Reprod, 1991, 6(3):443–445

    Article  PubMed  CAS  Google Scholar 

  12. Hill MJ, Miller KA, Frattarelli JL. A GnRH agonist and exogenous hormone stimulation protocol has a higher live-birth rate than a natural endogenous hormone protocol for frozen-thawed blastocyst-stage embryo transfer cycles: an analysis of 1391 cycles. Fertil Steril, 2010, 93(2):416–422

    Article  PubMed  Google Scholar 

  13. Dal Prato L, Borini A, Cattoli M, et al. Endometrial preparation for frozen-thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist. Fertil Steril, 2002, 77(5):956–960

    Article  Google Scholar 

  14. van de Vijver A, Polyzos NP, Van Landuyt L, et al. Cryopreserved embryo transfer in an artificial cycle: is GnRH agonist down-regulation necessary? Reprod Biomed Online, 2014, 29(5):588–594

    Article  PubMed  CAS  Google Scholar 

  15. AzimiNekoo E, Chamani M, Shahrokh Tehrani E, et al. Artificial Endometrial Preparation for Frozen-Thawed Embryo Transfer with or without Pretreatment with Depot Gonadotropin Releasing Hormone Agonist in Women with Regular Menses. J Family Reprod Health, 2015, 9(1):l–4

    Google Scholar 

  16. Broekmans FJ, Bernardus RE, Berkhout G, et al. Pituitary and ovarian suppression after early follicular and mid-luteal administration of a LHRH agonist in a depot formulation: decapeptyl CR. Gynecol Endocrinol, 1992, 6(3):153–161

    Article  PubMed  CAS  Google Scholar 

  17. Iwashita M, Kudo Y, Shinozaki Y, et al. Gonadotropinreleasing hormone increases serum human chorionic gonadotropin in pregnant women. Endoer J, 1993, 40(5):539–544

    CAS  Google Scholar 

  18. Casan EM, Raga F, Polan ML. GnRH mRNA and protein expression in human preimplantation embryos. Mol Hum Reprod, 1999, 5(3):234–239

    Article  PubMed  CAS  Google Scholar 

  19. De Leo V, Musacchio MC, Cappelli V, et al. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol, 2016, 14(1):38

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  20. Yu J, Ma Y, Wu Z, et al. Endometrial preparation protocol of the frozen-thawed embryo transfer in patients with polycystic ovary syndrome. Arch Gynecol Obstet, 2015, 291(1):201–211

    Article  PubMed  CAS  Google Scholar 

  21. Gong F, Li X, Zhang S, et al. A modified ultralong pituitary downregulation protocol improved endometrial receptivity and clinical outcome for infertile patients with polycystic ovarian syndrome. Exp Ther Med, 2015, 10(5):1865–1870

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  22. Refaat B, Dalton E, Ledger WL. Ectopic pregnancy secondary to in vitro fertilisation-embryo transfer: pathogenic mechanisms and management strategies. Reprod Biol Endocrinol, 2015, 13:30

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Shao R, Feng Y, Zou S, et al. The role of estrogen in the pathophysiology of tubal ectopic pregnancy. Am J Transi Res, 2012, 4(3):269–278

    CAS  Google Scholar 

  24. Zhu L, Li Y, Xu A. Influence of controlled ovarian hyper-stimulation on uterine peristalsis in infertile women. Hum Reprod, 2012, 27(9):2684–2689

    Article  PubMed  CAS  Google Scholar 

  25. Rickes D, Nickel I, Kropf S, etal. Increased pregnancy rates after ultralong postoperative therapy with gonadotropin releasing hormone analogs in patients with endometriosis. Fertil Steril, 2002, 78(4):757–762

    Article  PubMed  Google Scholar 

  26. Sallam HN, Garcia-Velasco JA, Arici A. Long-term pituitary down-regulation before in vitro fertilization (IVF) for women with endometriosis (Protocol). Cochrane Database Syst Rev, 2006, 1:CD004635

    Google Scholar 

  27. Franasiak JM, Holoch KJ, Yuan L, et al. Prospective assessment of midsecretory endometrial leukemia inhibitor factor expression versus avβ3 testing in women with unexplained infertility. Fertil Steril, 2014, 101(6):1724–1731

  28. 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 Sei Technolog Med Sei, 2016, 36(1):127–131

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Reproductive Medical Centre, Wuhan General Hospital of Guangzhou Military Region, Wuhan, 430070, China

    Di Xie, Shou-zhen Xie, Zhi-lan Chen, Ping Tuo, Rong Zhou & Juan Zhang

  2. Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction, Education Ministry of China, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan, 430070, China

    Fan Chen

Authors
  1. Di Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shou-zhen Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhi-lan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ping Tuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rong Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Juan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Juan Zhang.

Additional information

This study was supported by the Wu JiePing Medical Foundation (No. 320.6755.15032) and the Wuhan Science and Technology Project (No. 2016060101010030).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xie, D., Chen, F., Xie, Sz. et al. Artificial Cycle with or without a Depot Gonadotropin-releasing Hormone Agonist for Frozen-thawed Embryo Transfer: An Assessment of Infertility Type that Is Most Suitable. CURR MED SCI 38, 626–631 (2018). https://doi.org/10.1007/s11596-018-1923-0

Download citation

  • Received:

  • Revised:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-018-1923-0

Key words

Search

Navigation