Effect of Administration of Single Dose GnRH Agonist in Luteal Phase on Implantation Rate of Fresh ICSI Cycles

Sally Alaa,Nadia Al-Hilli,Mufeda Jwad

doi:10.28969/ijeir.v10.i2.r1

Abstract

The luteal phase (LP) in the fresh ICSI cycle is insufficient, adequate LP support is one of the approved treatments for improving implantation and pregnancy rates. It is generally known that the LP is inadequate after ovarian stimulation due to negative from supra-physiological blood levels of steroids released by numerous corporal luteal, LH concentrations are low during the luteal phase. In this study, patients were divided into two groups: (40) patients as study group; those who received GnRHa (Decapeptil 0.1 mg), three days after embryo transfer, in addition to conventional luteal phase support (LPS) in the LP to increase the implantation and pregnancy rate in IVF; and their control group (40) received standard LPS only. On the second day of stimulation, blood samples for FSH, LH, TSH, E2, and prolactin were taken. On the day of ovulation induction, measure E2, progesterone, and LH; and on the day of embryo transfers, measure progesterone and LH. The overall characteristics of the patients in both groups were not significantly different. There was also no significant change in the number of total oocytes, mean of metaphase II oocytes percent, cleavage rate, grade I embryo percent, or serum hormones level between the study and control groups (p > 0.05). GnRH agonist treatment in the luteal phase improves clinical pregnancy and implantation rate in fresh ICSI cycles but is not statistically significant.

Highlights

Infertility is a big issue that many couples confront at some point in their lives
There was no significant difference in total oocytes number, mean metaphase II oocytes percent, mean metaphase I percent, mean germinal vesicle oocyte percent, mean cleavage rate, mean grade I embryo percent, mean grade II embryos percent, or mean serum hormones level between the study and control groups (p > 0.05), as shown in Table 5 and Table 6
This study was designed to be a comparative prospective study that looked at the effect of a single dose of gonadotropin releasing hormone antagonist GnRH agonist (GnRHa) (Decapeptil 0.1 mg) on the outcome of intracytoplasmic sperm injection in infertile women who were undergoing an antagonist protocol with human chorionic gonadotrophin (HCG) trigger on day 6 after ova pick-up or day 3 after embryo transfer in addition to standard luteal phase support

Summary

Introduction

Infertility is a big issue that many couples confront at some point in their lives. Reproductive medicine faces a difficult task in dealing with infertility issues. Infertility is estimated to affect 10% to 15% of the world's population (Moridi et al, 2019 [1]). Infertility is defined as "the inability to achieve a clinical pregnancy following 12 months of regular, unprotected sexual intercourse" according to an updated worldwide dictionary on infertility and reproductive treatments (ZegersHochschild et al, 2017 [2]). Medical and/or surgical therapy of the underlying reason, fertility drugs, and assisted reproductive technologies (ARTs) are all part of infertility management (Nardelli et al, 2014 [3]). Despite considerable advances in assisted reproductive technology (ART) that have overcome many of the underlying reasons for infertility, pregnancy rates remain low (Zhang et al, 2013 [4])

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Conclusion