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

Zafardoust, Simin; Jeddi-Tehrani, Mahmood; Akhondi, Mohammad Mehdi; Sadeghi, Mohammad Reza; Kamali, Koorosh; Mokhtar, Sara; Badehnoosh, Bita; Fatemi, Farnaz; Mohammadzadeh, Afsaneh

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

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