2013년 미국불임학회(ASRM) P-121 Effect of GnRH-antagonist versus agonist on embryo quality by comparing the outcomes of FETs. (동결란 이식에서 GnRH 길항제 요법과 효능제 요법이 수정란의 상태에 어떠한 영향을 미치는가?)

JiHye Lee1, kyeong Ho Lee1, SeokGi Kim1, Il Hae Park1, Hong Gil Sun1 and Youn Young Kim1.
1 Mamapapa & baby OB&GY, 1367-5 Hwashin building 4th floor Dal-dong, Nam-gu Ulsan, X, Republic of Korea, 680-805

INTRODUCTION

It is still unclear whether detrimental effects of GnRH antagonist are oocyte quality or endometrial maturation. Frozen-thawed embryo transfer cycle provides a model to eliminate any detrimental effect of GnRH antagonist in the oocyte retrieval cycle. To assess whether the GnRH antagonist had a detrimental effect on embryo quality, we compared the frozen-thawed embryo transfer (FET) outcomes of GnRH agonist or GnRH antagonist protocols for COS in the previous oocyte retrieval cycle.

DESIGN

A retrospective study

MATERIALS AND METHODS

We analyzed 559 cycles from patients underwent FETs from January 2010 to November 2012. The patients were divided into two groups based on whether they had been treated using a GnRH agonist long protocol (group A, n=331) or a GnRH antagonist protocol (group B, n=228) during the previous oocyte retrieval cycle. FETs were performed to patients either in natural cycle or in a hormonally manipulated artificial cycle following preparation of the endometrium with estradiol and progesterone. Embryos were frozen on day 3 using a vitrification protocol and FETs were performed by same physician. We compared survival rates, embryo quality, pregnancy and ongoing rates.

RESULTS

There were no differences between both groups in patient age (35±4.4 in group A vs. 36±3.9 in group B), endometrial thickness (9.2±2.1 vs. 9.5±1.8), fully intact rates (69.2% vs. 66.9%), and survival rates (83.6% vs. 81.3%). And numbers of good quality embryos transferred were similar for the GnRH agonist and GnRH antagonist groups(57.5% vs. 60.5%). Pregnancy and ongoing rates were 33.8% vs. 37.3% and 32.0% vs. 33.8%, respectively, which was not statistically significantly different

CONCLUSION

The use of GnRH agonists or GnRH antagonists in oocyte retrieval cycles did not result in different outcomes for frozen-thawed embryo transfer in terms of pregnancy or ongoing rates. Our results suggest that GnRH antagonists do not have a detrimental effect on embryo quality.