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長短療程~增加弟凱得可以增加成功率1 2 3 4 5.7.9.10.8

Beneficial effect of luteal-phase GnRH agonist administration on embryo implantation after ICSI in both GnRH agonist- and antagonist-treated ovarian stimulation cycles

Jan Tesarik1,2,5, André Hazout3, Raquel Mendoza-Tesarik1,Nicolas Mendoza1 and Carmen Mendoza1,4
1 MAR&Gen, Molecular Assisted Reproduction and Genetics, Granada, Spain 2Laboratoire dEylau 3 ARCEFAR, Paris, France and 4 Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Campus Universitario Funetenueva, Granada, Spain

5 To whom correspondence should be addressed at: E-mail: cmendoza@ugr.es Abstract
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Abstract
Introduction
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BACKGROUND: GnRH agonist was recently suggested as a novel luteal-phase support that may act at different levels, including the pituitarygonadotrophs, the endometrium and the embryo itself. This prospectiverandomized study evaluates the effect of GnRH agonist administered in theluteal phase on ICSI outcomes in both GnRH agonist- and GnRH antagonist-treated ovarian stimulation protocols. METHODS: Six hundred women about to undergo ovarian stimulation for ICSI (300 using a long GnRH agonist protocol and 300 using a GnRH antagonist protocol) were enrolled in this study. Patients treated with each of these two protocols were randomly assigned to receive a single injection of GnRH agonist or placebo 6 days after ICSI. Implantation and live birth rates were the primary outcomes. RESULTS: Administration of 0.1 mg of GnRH agonist triptorelin on day 6 after ICSI led to a significant improvement of implantation and live birth rates after ICSI as compared with placebo. In GnRH antagonist-treated ovarian stimulation cycles, luteal-phase GnRH agonist alsoincreased ongoing pregnancy rate. Moreover, luteal-phase GnRH agonist administration increased luteal-phase serum HCG, estradiol and progesterone concentrations in both ovarian stimulation regimens. CONCLUSIONS: Luteal-phase GnRH agonist administration enhances ICSI clinical outcomes after GnRH agonist- and GnRH antagonist-treated ovarian stimulation cycles, possibly by a combination of effects on the embryo and the corpus luteum.
Key words: corpus luteum function/embryo developmental potential/GnRH agonist/GnRH antagonist/luteal-phase support

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