Frozen thawed embryo transfer cycles; A comparison of pregnancy outcomes with and without prior pituitary suppression by GnRH agonists: An RCT|
Samsami, Alamtaj; Chitsazi, Zohre & Namazi, Golnaz
Background: To perform an in-vitro fertilization cycle, pretreatment with
gonadotropin-releasing hormone (GnRH) agonist is widely used as a part of
controlled ovarian hyper-stimulation protocols to prevent endogenous luteinizing
hormone surge and spontaneous ovulation. GnRH agonist pretreatment is relatively
costly and there is a risk of hypo estrogenic side effect. It would also lengthen the
preparation period until pituitary desensitization occurs.
Objective: Our study is aimed at evaluating the pregnancy outcome rate of frozen
thawed embryo transfer with and without GnRH agonists pretreatment.
Materials and Methods: Women with documented infertility who were candidate
for frozen thawed embryo transfer were recruited and randomly assigned to two
groups. In group A (n=100), patients received GnRH agonist, Buserelin, to induce
pituitary desensitization prior to endometrial preparation and embryo transfer.
Individuals in group B (n=100) received steroid manipulation without prior downregulation
of the pituitary. Chemical pregnancy, implantation rate, clinical
pregnancy and ongoing pregnancy were measured and statistically compared
between the two groups.
Results: None of the outcome measures including clinical and chemical pregnancy
rates, implantation rate, and ongoing pregnancy rate showed significant difference
between the two groups. Similarly, the rate of miscarriage did not vary between the
Conclusion: In this study, we found that removing the GnRH agonists pretreatment
from the programmed cycles did not negatively influence the pregnancy outcome or
implantation rate. Moreover, it will cause a considerable reduction in cost of assisted
reproductive technology as well as adverse effects related to GnRH agonists, while
having a favorable implantation and pregnancy outcomes.
Embryo transfers; In vitro fertilization; Ovarian stimulation; Gonadotropin releasing hormone; Agonist.