Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Effect of Administration of Single Dose GnRH Agonist in Luteal Phase on Outcome of ICSI-ET Cycles in Women with Previous History of IVF/ICSI Failure: A Randomized Controlled Trial

Authors
Simin Zafardoust 1
Mahmood Jeddi-Tehrani 2
Mohammad Mehdi Akhondi 1
Mohammad Reza Sadeghi 2
Koorosh Kamali 1
Sara Mokhtar 1
Bita Badehnoosh 1
Farnaz Fatemi 1
Afsaneh Mohammadzadeh 1
1 Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
2 Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
Abstract
Background: GnRH agonist administration in the luteal phase has been suggested to beneficially affect the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) cycles. This blind randomized controlled study evaluates the effect of GnRH (Gonadotropine Releasing Hormone) agonist administration on ICSI outcome in GnRH antagonist ovarian stimulation protocol in women with 2 or more previous IVF/ICSI-ET failures. Methods: One hundred IVF failure women who underwent ICSI cycles and stimulated with GnRH antagonist ovarian stimulation protocol, were included in the study. Women were randomly assigned to intervention (received a single dose injection of GnRH agonist (0.1 mg of Decapeptil) subcutaneously 6 days after oocyte retrieval) and control (did not receive GnRH agonist) groups. Implantation and clinical pregnancy rates were the primary outcome measures. Results: Although the age of women, the number of embryos transferred in the current cycle and the quality of the transferred embryos were similar in the two groups, there was a significantly higher rate of implantation (Mann Whitney test, p=0.041) and pregnancy (32.6% vs. 12.5%, p=0.030, OR=3.3, 95%CI, 1.08 to 10.4) in the intervention group. Conclusion: Our results suggested that, in addition to routine luteal phase support using progesterone, administration of 0.1 mg of Decapeptil 6 days after oocyte retrieval in women with previous history of 2 or more IVF/ICSI failures led to a significant improvement in implantation and pregnancy rates after ICSI following ovarian stimulation with GnRH antagonist protocol.
Keywords
Decapeptil
GnRH agonist
GnRH antagonist
ICSI
Implantation failure
Intracytoplasmic Sperm Injection
IVF failure
Luteal phase support
  1. Jindal UN, Verma S, editors. Luteal Phase Support. London-United Kingdom: Jaypee Brothers, Medical Publishers; 2013. 622 p. (Rao KA, Carp HJA, Fischer F. Textbook of In Vitro Fertilization; vol. 2).
  2. Aflatoonian A, Asgharnia M, Alshohadaei FS. Comparison of progesterone administration before and after embryo transfer in ART cycles. J Reprod Infertil. 2004;5(1):44-51.
  3. Smitz J, Devroey P, Camus M, Deschacht J, Khan I, Staessen C, et al. The luteal phase and early pregnancy after combined GnRH-agonist/HMG treatment for superovulation in IVF or GIFT. Hum Reprod. 1988;3(5):585-90.
  4. Van Steirteghem AC, Smitz J, Camus M, Van Waesberghe L, Deschacht J, Khan I, et al. The luteal phase after in-vitro fertilization and related procedures. Hum Reprod. 1988;3(2):161-4.
  5. Devroey P, Bourgain C, Macklon NS, Fauser BC. Reproductive biology and IVF: ovarian stimulation and endometrial receptivity. Trends Endocrinol Metab. 2004;15(2):84-90.
  6. Garcia J, Jones GS, Acosta AA, Wright GL Jr. Corpus luteum function after follicle aspiration for oocyte retrieval. Fertil Steril. 1981;36(5):565-72.
  7. Pritts EA, Atwood AK. Luteal phase support in infertility treatment: a meta-analysis of the randomized trials. Hum Reprod. 2002;17(9):2287-99.
  8. van der Linden M, Buckingham K, Farquhar C, Kremer JA, Metwally M. Luteal phase support for assisted reproduction cycles. Cochrane Database Syst Rev. 2011;(10):CD009154.
  9. Isik AZ, Caglar GS, Sozen E, Akarsu C, Tuncay G, Ozbicer T, et al. Single-dose GnRH agonist administration in the luteal phase of GnRH antagonist cycles: a prospective randomized study. Reprod Biomed Online. 2009;19(4):472-7.
  10. Tesarik J, Hazout A, Mendoza-Tesarik R, Mendoza N, Mendoza C. Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles. Hum Reprod. 2006;21(10):2572-9.
  11. Oliveira JB, Baruffi R, Petersen CG, Mauri AL, Cavagna M, Franco JG Jr. Administration of single-dose GnRH agonist in the luteal phase in ICSI cycles: a meta-analysis. Reprod Biol Endocrinol. 2010;8:107.
  12. Kyrou D, Kolibianakis EM, Fatemi HM, Tarlatzi TB, Devroey P, Tarlatzis BC. Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: a systematic review and meta-analysis. Hum Reprod Update. 2011;17(6):734-40.
  13. Razieh DF, Maryam AR, Nasim T. Beneficial effect of luteal-phase gonadotropin-releasing hormone agonist administration on implantation rate after intracytoplasmic sperm injection. Taiwan J Obstet Gynecol. 2009;48(3):245-8.
  14. Sasaki K, Norwitz ER. Gonadotropin-releasing hormone/gonadotropin-releasing hormone receptor signaling in the placenta. Curr Opin Endocrinol Diabetes Obes. 2011;18(6):401-8.
  15. Wu S, Wilson MD, Busby ER, Isaac ER, Sherwood NM. Disruption of the single copy gonadotropin-releasing hormone receptor in mice by gene trap: severe reduction of reproductive organs and functions in developing and adult mice. Endocrinology. 2010;151(3):1142-52.
  16. Tesarik J, Greco E. The probability of abnormal preimplantation development can be predicted by a single static observation on pronuclear stage morphology. Hum Reprod. 1999;14(5):1318-23.
  17. Balasch J, Martinez F, Jove I, Cabre L, Coroleu B, Barri PN, et al. Inadvertent gonadotrophin-releasing hormone agonist (GnRHa) administration in the luteal phase may improve fecundity in in-vitro fertilization patients. Hum Reprod. 1993;8(7):1148-51.
  18. Elefant E, Biour B, Blumberg-Tick J, Roux C, Thomas F. Administration of a gonadotropin-releasing hormone agonist during pregnancy: follow-up of 28 pregnancies exposed to triptoreline. Fertil Steril. 1995;63(5):1111-3.
  19. Uehara S, Sakahira H, Tamura M, Watanabe T, Yajima A. Normal outcome following administration of gonadotropin-releasing hormone (GnRH) agonist during early pregnancy. Congenit Anom. 1998;38(1):81-5.doi: 10.1111/j.1741-4520.1998.tb00331.x/abstract
  20. Schroder AK, Katalinic A, Diedrich K, Ludwig M. Cumulative pregnancy rates and drop-out rates in a German IVF programme: 4102 cycles in 2130 patients. Reprod Biomed Online. 2004;8(5):600-6.
  21. Petersen CG, Mauri AL, Baruffi RL, Oliveira JB, Massaro FC, Elder K, et al. Implantation failures: success of assisted hatching with quarter-laser zona thinning. Reprod Biomed Online. 2005;10(2):224-9.
Journal of Reproduction & Infertility
Volume 16, Issue 2
Spring 2015
Pages 96-101