GnRh Agonist Treatment Improves Implantation and Pregnancy Rates of Frozen-Thawed Embryos Transfer.

OBJECTIVE

To study the effect of GnRh agonist administration prior to estrogen-progesterone preparation of the endometrium on the implantation rate in frozen-thawed embryo transfer (FET) cycles in infertile patients treated with IVF/ICSI.

DESIGN

Prospective controlled study.

SETTING

Private center in Alexandria, Egypt.

PATIENTS

Patients undergoing frozen-thawed embryo transfer FET.

INTERVENTIONS

Patients were divided into two groups, A and B. Group A patients consisted of 110 patients (110 cycles) who received daily subcutaneous injections of 0.1 mg of the GnRh agonist triptorelin starting from the mid-luteal phase of the cycle preceding the actual FET cycle. The dose was reduced to 0.05 mg from the second day of the cycle when daily oral estradiol valerate 6 mg was also started. Daily vaginal supplementation of micronized progesterone 400 mg b.d. was started after 12 days when the GnRh agonist was also stopped. Frozen-thawed embryos were transferred on day + 1 of their chronological age and when the endometrium reached 12 mm in thickness. Group B consisted of 100 patients (100 cycles) who started daily estradiol valerate 6 mg administration from the second day of the FET cycle and followed the same regimen but without prior treatment with triptorelin.

MAIN OUTCOME MEASURES

Implantation and pregnancy rates were compared among the two groups.

RESULTS

There was a significant increase in implantation rate in the GnRh agonist group (group A) compared to the estrogen and progesterone only group (group B) (44.1 vs. 21.1 %;  = 0.002*). The pregnancy rate was also significantly higher in group A compared to group B (65.5 vs. 42 %,  = 0.013*).

CONCLUSIONS

GnRh agonist administration during endometrial preparation for FET increases the implantation and pregnancy rates.