Endometrial Preparation for Frozen-Thawed Embryo Transfer With or Without Pretreatment With GnRH Agonist: A Randomized Controlled Trial at Two Centers

Front Endocrinol (Lausanne). 2021 Oct 18:12:722253. doi: 10.3389/fendo.2021.722253. eCollection 2021.

Abstract

Objective: This prospective randomized controlled trial compared the reproductive outcomes of frozen embryo transfer (FET) with hormone replacement treatment (HRT) with or without gonadotropin-releasing hormone agonist (GnRHa) pretreatment.

Methods: A total of 133 patients scheduled for HRT-FET mainly because of tubal and/or male factors who received two high-quality cleavage-stage embryos were enrolled at two participating centers. The GnRHa group (n = 65) received GnRHa pretreatment, while the control group (n = 68) did not. Analysis was based on the intention-to-treat (ITT) principle.

Results: Among the 133 participants, 130 (97.7%) underwent embryo transfer and 127 (95.5%) completed the protocol. The clinical pregnancy rate according to ITT did not differ between the GnRHa and control groups [39/65 (60.0%) vs. 41/68 (60.3%), p = 0.887]. The implantation rate (47.6% vs. 45.3%, p = 0.713), early pregnancy loss rate (5.1% vs. 19.5%, p = 0.09), and live birth rate (49.2% vs. 50.0%, p = 0.920) were also comparable between groups.

Conclusion: Pretreatment with GnRHa does not improve the reproductive outcomes for women receiving HRT-FET.

Clinical trial registration: The study was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-17014170; http://www.chictr.org.cn).

Keywords: GnRH agonist; endometrial preparation; frozen embryo transfer; hormone replacement treatment; reproductive outcomes.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Birth Rate
  • Blastocyst
  • Cryopreservation
  • Drug Administration Schedule
  • Embryo Implantation / drug effects
  • Embryo Transfer / methods*
  • Endometrium / drug effects*
  • Endometrium / pathology
  • Female
  • Fertility Agents, Female / administration & dosage*
  • Fertility Agents, Female / pharmacology
  • Gonadotropin-Releasing Hormone / agonists*
  • Hormone Replacement Therapy / methods*
  • Humans
  • Infant, Newborn
  • Intention to Treat Analysis
  • Live Birth
  • Male
  • Pregnancy

Substances

  • Fertility Agents, Female
  • Gonadotropin-Releasing Hormone

Associated data

  • ChiCTR/ChiCTR-IOR-17014170