Raquel Mendoza-Tesarik1, Nicolas Mendoza2, Cristina Conde López3, Jan Tesarik4. 1. Molecular Assisted Reproduction and Genetics, MAR&Gen Clinic, Camino de Ronda 2, Granada 18006, Spain. 2. Molecular Assisted Reproduction and Genetics, MAR&Gen Clinic, Camino de Ronda 2, Granada 18006, Spain; Department of Obstetrics and Gynecology, School of Medicine, Avenida de la Investigación 11, Granada 18016, Spain. 3. Molecular Assisted Reproduction and Genetics, MAR&Gen Clinic, Camino de Ronda 2, Granada 18006, Spain; Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, Campus de Cartuja, Granada 18071, Spain. 4. Molecular Assisted Reproduction and Genetics, MAR&Gen Clinic, Camino de Ronda 2, Granada 18006, Spain. Electronic address: jtesarik@clinicamargen.com.
Abstract
RESEARCH QUESTION: This study aimed to identify women with IVF failure associated with low serum progesterone levels after embryo transfer in HCG-triggered cycles and to evaluate the effects of gonadotrophin-releasing hormone (GnRH) agonist, administered after embryo transfer, on serum progesterone and pregnancy outcomes in these cases. DESIGN: Fifty women who failed to achieve an ongoing clinical pregnancy and had abnormally low luteal-phase serum progesterone concentrations in their first IVF attempt were assigned to two matched groups in their subsequent attempt. Twenty-five women were treated with the original protocol plus14 daily injections of GnRH agonist, beginning on the day of oocyte recovery, in their second IVF attempt (group 1). These women were matched to 25 women with the same characteristics and outcomes in their first IVF attempt who underwent the second IVF attempt without the use of GnRH agonist after embryo transfer (group 2). In both groups, the two sequential attempts were compared for serum progesterone concentration 14 days after oocyte recovery and pregnancy outcome. RESULTS: The patients in group 1 had significantly higher progesterone levels 14 days after oocyte recovery in the second attempt compared with the first attempt (P < 0.001), and 12 (48%) of them achieved clinical pregnancy and birth. No significant differences in pregnancy outcome or in the serum progesterone concentration were observed between the first and the second attempt in group 2. CONCLUSIONS: In patients with luteal phase deficiency, the administration of GnRH agonist after embryo transfer increases serum progesterone concentration and improves the chance of pregnancy and birth.
RESEARCH QUESTION: This study aimed to identify women with IVF failure associated with low serum progesterone levels after embryo transfer in HCG-triggered cycles and to evaluate the effects of gonadotrophin-releasing hormone (GnRH) agonist, administered after embryo transfer, on serum progesterone and pregnancy outcomes in these cases. DESIGN: Fifty women who failed to achieve an ongoing clinical pregnancy and had abnormally low luteal-phase serum progesterone concentrations in their first IVF attempt were assigned to two matched groups in their subsequent attempt. Twenty-five women were treated with the original protocol plus14 daily injections of GnRH agonist, beginning on the day of oocyte recovery, in their second IVF attempt (group 1). These women were matched to 25 women with the same characteristics and outcomes in their first IVF attempt who underwent the second IVF attempt without the use of GnRH agonist after embryo transfer (group 2). In both groups, the two sequential attempts were compared for serum progesterone concentration 14 days after oocyte recovery and pregnancy outcome. RESULTS: The patients in group 1 had significantly higher progesterone levels 14 days after oocyte recovery in the second attempt compared with the first attempt (P < 0.001), and 12 (48%) of them achieved clinical pregnancy and birth. No significant differences in pregnancy outcome or in the serum progesterone concentration were observed between the first and the second attempt in group 2. CONCLUSIONS: In patients with luteal phase deficiency, the administration of GnRH agonist after embryo transfer increases serum progesterone concentration and improves the chance of pregnancy and birth.
Authors: Raoul Orvieto; Christos A Venetis; Human M Fatemi; Thomas D'Hooghe; Robert Fischer; Yulia Koloda; Marcos Horton; Michael Grynberg; Salvatore Longobardi; Sandro C Esteves; Sesh K Sunkara; Yuan Li; Carlo Alviggi Journal: Front Endocrinol (Lausanne) Date: 2021-05-10 Impact factor: 5.555