Published: 29 March 2024
https://doi.org/10.3390/biomedicines12040760
Nguyen-Tuong Ho 1,2,3, Dang Khanh Ngan Ho 4, Xuan Hong Tomai 5, Nam Nhat Nguyen 2, Hung Song Nguyen 6, Yu-Ming Hu 1, Shu-Huei Kao 7,8,* and Chii-Ruey Tzeng 1,2,*
Authors information
1Taipei Fertility Center, Taipei 110, Taiwan
2College of Medicine, Taipei Medical University, Taipei 110, Taiwan
3IVFMD, My Duc Hospital, Ho Chi Minh City 700000, Vietnam
4School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110, Taiwan
5Office of International Relations, University of Medicine and Pharmacy, Ho Chi Minh City 700000, Vietnam
6Division of Infectious Disease, Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam
7School of Medical Laboratory Science and Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
8Ph.D. Program in Medical Biotechnology, College of Medical Science and Technology, Taipei Medical University, Taipei 110, Taiwan
*Authors to whom correspondence should be addressed.
Abstract
This study investigates the effect of GnRHa pretreatment on pregnancy outcomes in artificial endometrial preparation for frozen–thawed embryo transfer (AC-FET) cycles. A systematic review of English language studies published before 1 September 2022, was conducted, excluding conference papers and preprints. Forty-one studies involving 43,021 participants were analyzed using meta-analysis, with a sensitivity analysis ensuring result robustness. The study found that GnRHa pretreatment generally improved the clinical pregnancy rate (CPR), implantation rate (IR), and live birth rate (LBR). However, discrepancies existed between randomized controlled trials (RCTs) and observational studies; RCTs showed no significant differences in outcomes for GnRHa-treated cycles. Depot GnRHa protocols outperformed daily regimens in LBR. Extended GnRHa pretreatment (two to five cycles) significantly improved CPR and IR compared to shorter treatment. Women with polycystic ovary syndrome (PCOS) saw substantial benefits from GnRHa pretreatment, including improved CPR and LBR and reduced miscarriage rates. In contrast, no significant benefits were observed in women with regular menstruation. More rigorous research is needed to solidify these findings.
Keywords: gonadotropin-releasing hormone agonist; pituitary suppression; frozen–thawed embryo transfer; pregnancy outcomes