Abstract
Objective
To study the effect of GnRh agonist administration prior to estrogen–progesterone preparation of the endometrium on the implantation rate in frozen–thawed embryo transfer (FET) cycles in infertile patients treated with IVF/ICSI.
Design
Prospective controlled study.
Setting
Private center in Alexandria, Egypt.
Patients
Patients undergoing frozen–thawed embryo transfer FET.
Intervention(s)
Patients were divided into two groups, A and B. Group A patients consisted of 110 patients (110 cycles) who received daily subcutaneous injections of 0.1 mg of the GnRh agonist triptorelin starting from the mid-luteal phase of the cycle preceding the actual FET cycle. The dose was reduced to 0.05 mg from the second day of the cycle when daily oral estradiol valerate 6 mg was also started. Daily vaginal supplementation of micronized progesterone 400 mg b.d. was started after 12 days when the GnRh agonist was also stopped. Frozen–thawed embryos were transferred on day + 1 of their chronological age and when the endometrium reached 12 mm in thickness. Group B consisted of 100 patients (100 cycles) who started daily estradiol valerate 6 mg administration from the second day of the FET cycle and followed the same regimen but without prior treatment with triptorelin.
Main Outcome Measures
Implantation and pregnancy rates were compared among the two groups.
Results
There was a significant increase in implantation rate in the GnRh agonist group (group A) compared to the estrogen and progesterone only group (group B) (44.1 vs. 21.1 %; P = 0.002*). The pregnancy rate was also significantly higher in group A compared to group B (65.5 vs. 42 %, P = 0.013*).
Conclusions
GnRh agonist administration during endometrial preparation for FET increases the implantation and pregnancy rates.
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The authors have no conflict of interest.
Ethical Approval
All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Sherif Anis Hebisha is a Lecturer of Obstetrics and Gynecology at Alexandria University Faculty of Medicine, Embryology Laboratory Director of Madina Fertility Center and Clinical fellowship at Yale University OBGYN department. H. M. Adel is a Lecturer of Obstetrics and Gynecology at Faculty of Medicine, Alexandria University.
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Hebisha, S.A., Adel, H.M. GnRh Agonist Treatment Improves Implantation and Pregnancy Rates of Frozen–Thawed Embryos Transfer. J Obstet Gynecol India 67, 133–136 (2017). https://doi.org/10.1007/s13224-016-0936-5
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DOI: https://doi.org/10.1007/s13224-016-0936-5