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The effect of ovarian stimulation on aneuploidy of early aborted tissues and preimplantation blastocysts: comparison of the GnRH agonist long protocol with the GnRH antagonist protocol

  • Assisted Reproduction Technologies
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Abstract

Purpose

To compare aneuploidy rates in early aborted tissues or blastocysts between in vitro fertilization (IVF) cycles after the gonadotropin-releasing hormone (GnRH) antagonist (GnRH-ant) protocol or the GnRH agonist (GnRH-a) long protocol.

Methods

This was a retrospective cohort study from a university-affiliated fertility center. In total, 550 early miscarriage patients who conceived through IVF/intracytoplasmic sperm injection (ICSI) after receiving the GnRH-ant or GnRH-a long protocol were analyzed to compare aneuploidy rates in early aborted tissues. To compare aneuploidy rates in blastocysts, 404 preimplantation genetic testing for aneuploidy (PGT-A) cycles with the GnRH-ant protocol or GnRH-a long protocol were also analyzed.

Results

For early miscarriage patients who conceived through IVF/ICSI, compared to the GnRH-a long protocol group, the GnRH-ant protocol group had a significantly higher rate of aneuploidy in early aborted tissues (48.51% vs. 64.19%). Regarding PGT-A cycles, the rate of blastocyst aneuploidy was significantly higher in the GnRH-ant protocol group than the GnRH-a long protocol group (39.69% vs. 52.27%). After stratification and multiple linear regression, the GnRH-ant regimen remained significantly associated with an increased risk of aneuploidy in early aborted tissues and blastocysts [OR (95% CI) 1.81 (1.21, 2.71), OR (95% CI) 1.65 (1.13, 2.42)]. Furthermore, the blastocyst aneuploidy rate in the GnRH-ant protocol group was significantly higher but only in young and normal ovarian responders [OR (95% CI) 5.07 (1.99, 12.92)].

Conclusion

Compared to the GnRH-a long protocol, the GnRH-ant protocol is associated with a higher aneuploidy rate in early aborted tissues and blastocysts. These results should be confirmed in a multicenter, randomized controlled trial.

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Data availability

All datasets generated for this study are included in the article/Supplementary Material.

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Acknowledgements

The authors gratefully acknowledge the patients who participated in this study.

Funding

This work was supported by the National Natural Science Foundation of China (81671463) and the Shaanxi Province Key R & D Program General Project (2021SF-012).

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Authors and Affiliations

  1. Center for Reproductive Medicine, Department of Gynecology & Obsterics, Tang Du Hospital, the Air Force Military Medical University, Xi’an, Shaan xi, People’s Republic of China

    Jun Wang, Jing Zhang, Nan Zhao, Yuan Ma, Xiyi Wang, Xingqing Gou, Ying Ju, Hengde Zhang, Shuqiang Chen & Xiaohong Wang

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  1. Jun Wang
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  4. Yuan Ma
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Contributions

Jun Wang collected the data and prepared all the tables and wrote the main manuscript, Jing Zhang and Nan Zhao collected the data, Shuqiang Chen searched the literature and designed the study, and Xiaohong Wang revised the manuscript. The author(s) read and approved the final manuscript.

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Correspondence to Shuqiang Chen or Xiaohong Wang.

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The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study was approved by the ethics committee of the Tang Du Hospital of the Air Force Military Medical University, China (K202108-09). All patients provided written informed consent.

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Wang, J., Zhang, J., Zhao, N. et al. The effect of ovarian stimulation on aneuploidy of early aborted tissues and preimplantation blastocysts: comparison of the GnRH agonist long protocol with the GnRH antagonist protocol. J Assist Reprod Genet 39, 1927–1936 (2022). https://doi.org/10.1007/s10815-022-02557-2

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