Journal Article

Pretreatment with a GnRH agonist and hormone replacement treatment protocol could not improve live birth rate for PCOS women undergoing frozen-thawed embryo transfer cycles

Wen, Wen, Shi, Juanzi, Liu, Xitong, Bai, Haiyan

2021

Overview

Background The ideal protocols of endometrial preparation for polycystic ovary syndrome (PCOS) patients are lacking and need further declaration. Our objective was to compare the clinical outcomes of frozen-thawed embryo transfer (FET) with and without pretreatment gonadotropin-releasing hormone agonist (GnRHa) in PCOS patients. Methods In this retrospective cohort study, we used propensity score matching (PSM) to compare the live birth rate between patients who underwent FET with hormone replacement treatment (HRT) and patients with GnRHa pretreatment (GnRHa + HRT). Patients using GnRHa + HRT ( n  = 514) were matched with 514 patients using HRT. Results The live birth rate was higher in the GnRHa + HRT group compared with the HRT group with no significant difference (60.12% vs 56.03%, p  = 0.073). The clinical pregnancy rate (75.29% vs 70.62%), miscarriage rate (14.20% vs 13.81%) and ectopic pregnancy rate (0.39% vs 0.19%) were similar between the two groups. The preterm birth rate in GnRHa + HRT was higher than HRT (20.23% vs 13.04%). No difference was found in live birth between GnRHa +HRT and HRT before adjusting for covariates (crude OR 1.22, 95%CI, 0.99–1.51, p  = 0.062) and after PSM (OR 1.47, 95%CI, 0.99–2.83, p  = 0.068). In addition, there is a marginally difference after adjusting for covariates (aOR 1.56, 95%CI, 1.001–2.41, p  = 0.048), this finding with p -value close to 0.05 represent insufficient empirical evidence. Similar results were obtained after propensity score matching in the entire cohort. Conclusions GnRHa pretreatment could not improve the live birth rate in women with PCOS.

• Publisher: BioMed Central,Springer Nature B.V,BMC
• Subject: Adult / Age / Agonists / Birth rate / Body mass index / China - epidemiology / Clinical outcomes / Cohort Studies / Cryopreservation / Drug dosages / Embryo Transfer / Embryos / Endometrial preparation / Endometrium - drug effects / Estrogens / Estrogens - therapeutic use / Female / Frozen-thawed embryo transfer / Gonadotropin-Releasing Hormone - agonists / Gonadotropin-Releasing Hormone - therapeutic use / Gynecology / Hormone Replacement Therapy / Humans / Infertility / Live Birth - epidemiology / Live birth rate / Maternal and Child Health / Medicine / Medicine & Public Health / Miscarriage / Polycystic ovary syndrome / Polycystic Ovary Syndrome - complications / Pregnancy / Pregnancy complications / Pregnancy Outcome - epidemiology / Pregnancy Rate / Premature birth / Propensity Score / Reproductive Medicine / Research Article / Retrospective Studies / Standard deviation / Ultrasonic imaging / Vagina / Variables / Womens health