Comparison of Reproductive Outcomes on addition of GnRH agonist for Luteal phase Support in Antagonist IVF cycle

Abstract

Background: The luteal phase supplementation was reported to be necessary in Controlled Ovarian Hyperstimulation cycles for IVF or ICSI, independently when agonistsor antagonist were used for pituitary desensitization. Theeffectiveness of GnRH agonist in luteal phase supplementation remains controversial.Aims and Objectives: This study aimed at comparing theclinical outcomes of addition of GnRH agonist for lutealphase support in antagonist IVF cycle.Materials and Methods: A cross-sectional study of 150eligible clients who underwent assisted reproduction program in two autonomous IVF centers between 1st January,2017 and 31st December, 2020. Clients were divided intotwo groups; (I) Antagonist stimulation protocol with progesterone and oestradiol valerate and (II) Antagonist Protocol with a single bolus of buserelin in addition to progesterone and oestradiol valerate for luteal phase support. Theprimary outcome was live birth rates while the secondaryoutcomes were clinical pregnancy, miscarriage rates andthe safety for OHSS.Results: There were no statistically significant differencesbetween the number of oocyte received, fertilized, embryosavailability for transfer, duration of infertility, duration ofFSH usage, endometrial thickness and OHSS risk betweenthe groups (p>0.05). The clinical pregnancy and live birthrates were more in group II while the miscarriage rate waslower compared to group I. The differences were statistically significant (p < 0.005).Conclusion: From this study, buserelin addition to the luteal phase of antagonist cycles appears to improve pregnancy outcomes with no associated increase in OHSS risk.Further multi- centered studies with larger sample sizes arerequired to validate these findings.