Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (10): 63-68.doi: 10.6040/j.issn.1671-7554.0.2023.0500

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Effects of GnRH-a pretreatment on the pregnancy outcomes of frozen embryo transplantation in patients with endometriosis

ZHANG Lixia1,2,3, TIAN Yizheng1, LYU Shangge1, ZHANG Yanan1,2, YAN Lei1,2   

  1. 1.Center for Reproductive Medicine, Cheeloo College of Medicine Shandong University, Jinan 250021, Shandong, China;
    2. Department of Gynecology, Reproductive Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    3. Maternal and Child Health and Family Planning Service Center of Yanggu County, Liaocheng 252300, Shandong, China
  • Published:2023-11-08

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Abstract: Objective To investigate the effects of pretreatment of gonadotrophin releasing hormone agonist(GnRH-a)for hormone replacement treatment(HRT)on the pregnancy outcomes in patients with endometriosis(EMs)after frozen embryo transplantation(FET). Methods Clinical data of 643 EMs patients who received FET in the Affiliated Reproductive Hospital of Shandong University during Jan. 2016 and Dec. 2019 were retrospectively analyzed. According to the endometrial preparation regimen, the patients were divided into experimental group(GnRH-a+HRT group, 261 frozen embryo transfer cycles)and control group(HRT group, 382 frozen embryo transfer cycles). The pregnancy outcomes were compared between the two groups, including live birth rate and abortion rate. Binary Logistic regression was used to correct confounding factors affecting pregnancy outcomes. Results There were no significant differences in the number of days of basic luteinizing hormone(LH), basic estrogen(E2), basic prolectin(PRL), basic thyrotropin(TSH), gonadotropin(Gn)and infertility types between the two groups(P>0.05). The age, basic follicle stimulating hormone(FSH), total amount of Gn and daily intimal thickness of human chorionic gonadotropin(HCG)were higher in the GnRH-a+HRT group, while anti-Mullerian hormone(AMH), antral follicle count(AFC), body mass index(BMI)and basic androgen(T0)were lower in the HRT group(P<0.05). After adjusting for confounders, the GnRH-a+HRT group was associated with a lower risk of miscarriage(OR=0.607, 95%CI=0.378-0.973, P=0.038)but not with live birth rate. Old age(OR=0.931, 95%CI=0.891-0.973, P=0.002)and high FSH level(OR=0.924, 95%CI=0.855-0.998, P=0.043)were negatively associated with live birth rate. Conclusion GnRH-a pretreatment for endometriosis patients undergoing FET before HRT can reduce the risk of abortion, but cannot significantly improve the live birth rate. Further study is needed to confirm the conclusion.

Key words: Endometriosis, Gonadotropin-releasing hormone agonist, Hormone replacement treatment, Freeze-thaw embryo transfer, Pregnancy outcomes

CLC Number: 

  • R711.71
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