Medical Center for Human Reproduction, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
J Int Med Res. 2020 Jun;48(6):300060520926026. doi: 10.1177/0300060520926026.
To evaluate the efficacy and safety of multiple- versus single-dose gonadotropin-releasing hormone agonist (GnRH-a) addition to luteal phase support (LPS), in patients with a first in vitro fertilization (IVF) failure associated with luteal phase deficiency (LPD).
Eighty patients with a first IVF failure associated with LPD were randomly assigned into single-dose and multiple-dose GnRH-a groups. In the second IVF attempt, patients in the single-dose group were given standard LPS plus a single dose of GnRH-a 6 days after oocyte retrieval. Patients in the multiple-dose group received standard LPS plus 14 daily injections of GnRH-a. Children conceived were followed up for 2 years.
Pregnancy (67.5% vs. 42.5%), clinical pregnancy (50.0% vs. 22.5%), and live birth rates (42.5% vs. 20.0%) were significantly higher in the multiple-dose versus single-dose GnRH-a group. Patients in the multiple-dose GnRH-a group had significantly higher progesterone levels 14 days after oocyte recovery (35.9 vs. 21.4 ng/mL). No significant difference existed in the status at birth or developmental and behavior assessments of 2-year-old children conceived in both groups.
Daily addition of GnRH-a to standard LPS can achieve better pregnancy outcomes with a sustained safety profile in patients with a first IVF failure associated with LPD.
评估黄体期支持（LPS）中添加多次与单次剂量促性腺激素释放激素激动剂（GnRH-a）对与黄体期缺陷（LPD）相关的首次体外受精（IVF）失败患者的疗效和安全性。
将 80 例与 LPD 相关的首次 IVF 失败患者随机分为单次剂量和多次剂量 GnRH-a 组。在第二次 IVF 尝试中，单次剂量组患者在取卵后 6 天给予标准 LPS 加单次 GnRH-a 剂量。多次剂量组患者接受标准 LPS 加 14 天每日 GnRH-a 注射。受孕的儿童随访 2 年。
多次剂量 GnRH-a 组的妊娠率（67.5% vs. 42.5%）、临床妊娠率（50.0% vs. 22.5%）和活产率（42.5% vs. 20.0%）显著高于单次剂量 GnRH-a 组。多次剂量 GnRH-a 组患者取卵后 14 天的孕激素水平（35.9 与 21.4ng/ml）显著升高。两组受孕的儿童在出生状况、2 岁儿童发育和行为评估方面无显著差异。
在与 LPD 相关的首次 IVF 失败患者中，每日添加 GnRH-a 至标准 LPS 可以获得更好的妊娠结局，并具有持续的安全性。
