GnRH agonist versus GnRH antagonist in ovarian stimulation: the role of endometrial receptivity

2008 ◽  
Vol 90 (4) ◽  
pp. 1294-1296 ◽  
Author(s):  
Raoul Orvieto ◽  
Simion Meltzer ◽  
Jacob Rabinson ◽  
Efraim Zohav ◽  
Eyal Y. Anteby ◽  
...  
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Endometrial Receptivity

GnRH agonist versus GnRH antagonist in ovarian stimulation: the role of elevated peak serum progesterone levels

2013 ◽  
Vol 29 (9) ◽  
pp. 843-845 ◽  
Author(s):  
Raoul Orvieto ◽  
Ravit Nahum ◽  
Simion Meltzer ◽  
Gadi Liberty ◽  
Eyal Y. Anteby ◽  
...  
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Peak Serum ◽  
Serum Progesterone

scholarly journals Long-Acting GnRH Agonist Improves IVF Outcomes of Young Patients with Diminished Ovarian Reserve by Increasing Endometrial Receptivity.

2020 ◽  
Author(s):  
xuemei Liu ◽  
Hongchu Bao ◽  
Qinglan Qu ◽  
Zhenyu Guo ◽  
Wenshu Li ◽  
...  
Keyword(s):  
Gnrh Agonist ◽  
Ovarian Reserve ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Young Patients ◽  
Follicular Phase ◽  
Endometrial Receptivity ◽  
Cancellation Rate ◽  
Long Acting ◽  
Long Protocol

Abstract Background: Up to now, there is not sufficient evidence to recommend a treatment optimizing in vitro fertilization (IVF) outcomes for diminished ovarian reserve (DOR). This study is aimed to investigate whether long-acting gonadotrophin-releasing hormone (GnRH) agonist long protocol in follicular phase could improve the IVF cycle outcomes for young patients with DOR when compared with GnRH antagonist and mild ovarian stimulation protocols. Methods: This retrospective cohort study was carried out from June 2015 to March 2019. 338 patients aged 20-40 years with DOR who underwent first IVF between were enrolled. These patients were assigned to three groups depending on the ovarian stimulation protocols. The outcome parameters of IVF were compared in each group. The demographic and reproductive characteristics were calculated by Mann-Whitney, Kruskal-Wallis or chi-square test as appropriate. We evaluated the clinical outcomes of IVF cycle between the three groups using univariate and multivariate logistic regression analyses. In addition, we evaluated the morphology and coverage of pinopode and expression of HOXA10 in endometrium during implantation window between three groups by scanning electron microscope and qRT-PCR.Results: Patients who received long-acting GnRH agonist long protocol had significantly higher clinical pregnancy rates (66.67%, 42.17% and 39.02%, respectively; P=.010 and .005), implantation rates (46.15%, 29.71%, and 28.57%, respectively; P=.041 and .025) and ongoing pregnancy rates (60.00%, 34.94%, and 36.59%, respectively; P=.018 and .004). They also had significantly higher duration of stimulation, total dose of gonadotrophins and endometrial thickness than the other two groups (P＜.001). However, serum luteinizing hormone (LH) and estradiol (E2) level on gonadotrophins initiation day, serum LH level on human chorionic gonadotropin (hCG) day, the embryos transferred cancellation rate and abnormal endometrium rate were significantly lower among women who received long-acting GnRH agonist (P＜.001). In addition, we found that long-acting GnRH agonist could improve the development of pinopode and mRNA of HOXA10 (P＜.05).Conclusions: To our knowledge, this is the first time that the benefit of long-acting GnRH agonist long protocol in follicular phase in young DOR patients has been reported. Though this novel protocol may have further suppressed response, it can increase endometrial receptivity, reduce cycle cancellation rate and improve IVF cycle clinical outcomes for these patients compared with mild stimulation and GnRH antagonist protocols.

scholarly journals Progestin primed ovarian stimulation using corifollitropin alfa in PCOS women effectively prevents LH surge and reduces injection burden compared to GnRH antagonist protocol

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ting-Chi Huang ◽  
Mei-Zen Huang ◽  
Kok-Min Seow ◽  
Ih-Jane Yang ◽  
Song-Po Pan ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Gnrh Agonist ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Polycystic Ovary ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Lh Surge ◽  
Corifollitropin Alfa ◽  
Premature Lh Surge

AbstractUtilizing corifollitropin alfa in GnRH antagonist (GnRHant) protocol in conjunction with GnRH agonist trigger/freeze-all strategy (corifollitropin alfa/GnRHant protocol) was reported to have satisfactory outcomes in women with polycystic ovary syndrome (PCOS). Although lessening in gonadotropin injections, GnRHant were still needed. In addition to using corifollitropin alfa, GnRHant was replaced with an oral progestin as in progestin primed ovarian stimulation (PPOS) to further reduce the injection burden in this study. We try to investigate whether this regimen (corifollitropin alfa/PPOS protocol) could effectively reduce GnRHant injections and prevent premature LH surge in PCOS patients undergoing IVF/ICSI cycles. This is a retrospective cohort study recruiting 333 women with PCOS, with body weight between 50 and 70 kg, undergoing first IVF/ICSI cycle between August 2015 and July 2018. We used corifollitropin alfa/GnRHant protocol prior to Jan 2017 (n = 160), then changed to corifollitropin alfa/PPOS protocol (n = 173). All patients received corifollitropin alfa 100 μg on menstruation day 2/3 (S1). Additional rFSH was administered daily from S8. In corifollitropin alfa/GnRHant group, cetrorelix 0.25 mg/day was administered from S5 till the trigger day. In corifollitropin alfa/PPOS group, dydrogesterone 20 mg/day was given from S1 till the trigger day. GnRH agonist was used to trigger maturation of oocyte. All good quality day 5/6 embryos were frozen, and frozen-thawed embryo transfer (FET) was performed on subsequent cycle. A comparison of clinical outcomes was made between the two protocols. The primary endpoint was the incidence of premature LH surge and none of the patients occurred. Dydrogesterone successfully replace GnRHant to block LH surge while an average of 6.8 days of GnRHant injections were needed in the corifollitropin alfa/GnRHant group. No patients suffered from ovarian hyperstimulation syndrome (OHSS). The other clinical outcomes including additional duration/dose of daily gonadotropin administration, number of oocytes retrieved, and fertilization rate were similar between the two groups. The implantation rate, clinical pregnancy rate, and live birth rate in the first FET cycle were also similar between the two groups. In women with PCOS undergoing IVF/ICSI treatment, corifollitropin alfa/PPOS protocol could minimize the injections burden with comparable outcomes to corifollitropin alfa/GnRHant protocol.

P–602 Pregnancy outcomes of progestin primed ovarian stimulation protocol, GnRH antagonist protocol and GnRH agonist protocol for young patients undergoing PGT-M

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Y Li ◽  
W Zhao ◽  
X Liang
Keyword(s):  
Genetic Testing ◽  
Gnrh Agonist ◽  
Pregnancy Outcomes ◽  
Ovarian Stimulation ◽  
Gnrh Antagonist ◽  
Young Patients ◽  
Stimulation Protocol ◽  
Preimplantation Genetic Testing ◽  
Gnrh Antagonist Protocol ◽  
Antagonist Protocol

Abstract Study question To investigate the pregnancy outcomes of progestin primed ovarian stimulation protocol, GnRH antagonist protocol and GnRH agonist protocol for young patients undergoing preimplantation genetic testing for monogenic gene diseases. Summary answer PPOS protocol could reduce the normal chromosome formation and further development potential of embryos, suggesting that the PPOS protocol should be used cautiously. What is known already GnRH antagonist protocol (GnRHant) and GnRH agonist protocol (GnRHa) have been used in clinic for many years as routine regimens, and their ovarian stimulation effects and pregnancy outcomes have been confirmed by a large number of literatures. As a new protocol in recent years, the reports of pregnancy outcomes of progestin primed ovarian stimulation protocol (PPOS) are inconsistent. Study design, size, duration This retrospective cohort study was performed in a reproduction center from a tertiary hospital between September 2018 and November 2020 which included 147 young patients (<35 year old) undergoing preimplantation genetic testing for monogenic gene diseases (PGT-M) after stimulated by progestin primed ovarian stimulation protocol (n = 44), GnRH antagonist protocol (n = 60) or GnRH agonist protocol (n = 43). Participants/materials, setting, methods This study included 147 young patients (<35 year old) undergoing preimplantation genetic testing for monogenic gene diseases (PGT-M) after stimulated by progestin primed ovarian stimulation protocol (PPOS, n = 44), GnRH antagonist protocol (GnRHant, n = 60) or GnRH agonist protocol (GnRHa, n = 43). The primary outcomes were normal karyotype embryo rate and live birth rate. The embryological and clinical outcomes were measured. Main results and the role of chance Basic characteristics such as infertility duration, age, and body mass index (BMI) were comparable in study groups. No significant difference was found in the number oocytes retrieved or viable embryos between the groups. Normal karyotype embryo rate of PPOS protocol was significantly lower than GnRHant and GnRHa protocol (57.6% for PPOS vs 76.0% for GnRHant vs 67.3% for GnRHa). No significant difference were found in chemical pregnancy rate (77.3% for PPOS vs 73.3% for GnRHant vs 74.4% for GnRHa) or clinical pregnancy rate (69.8% for PPOS vs 71.7% for GnRHant vs 72.5% for GnRHa). While live birth rate of PPOS protocol was significantly lower than GnRHant and GnRHa protocol ( 45.5% for PPOS vs 58.3% for GnRHant vs 72.2% for GnRHa). Limitations, reasons for caution This is a preliminary study which needs to be further confirmed by large-scale clinical studies. Wider implications of the findings: Although this is a preliminary study which needs to be further confirmed by large-scale clinical studies, the current results suggest that the application of PPOS should be cautious. Trial registration number -

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