title: Does prolonged pituitary down-regulation with gonadotropin-releasing hormone agonist improve the live-birth rate in in vitro fertilization treatment?
abstract: OBJECTIVE
  To evaluate the effects of a prolonged duration of gonadotropin-releasing hormone agonist (GnRH-a) in pituitary down-regulation for controlled ovarian hyperstimulation (COH) on the live-birth rate in nonendometriotic women undergoing in vitro fertilization and embryo transfer (IVF-ET).
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University-affiliated hospital.
  
  
  METHODS
  Normogonadotropic women undergoing IVF.
  
  
  METHODS
  Three hundred seventy-eight patients receiving a prolonged pituitary down-regulation with GnRH-a before ovarian stimulation and 422 patients receiving a GnRH-a long protocol.
  
  
  METHODS
  Live-birth rate per fresh ET.
  
  
  RESULTS
  In comparison with the long protocol, the prolonged down-regulation protocol required a higher total dose of gonadotropins. A lower serum luteinizing hormone (LH) level on the starting day of gonadotropin and the day of human chorionic gonadotropin (hCG) and a fewer number of oocytes and embryos were observed in the prolonged down-regulation protocol. However, the duration of stimulation and number of high-quality embryos were comparable between the two groups. A statistically significantly higher implantation rate (50.27% vs. 39.69%), clinical pregnancy rate (64.02% vs. 56.87%) and live-birth rate per fresh transfer cycle (55.56% vs. 45.73%) were observed in the prolonged protocol.
  
  
  CONCLUSIONS
  Prolonged down-regulation in a GnRH-a protocol might increase the live-birth rates in normogonadotropic women.
authors.affiliation: Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China. Electronic address: rjz174@126.com.
authors.forename: Jianzhi
authors.initials: J
authors.lastname: Ren
authors.affiliation: Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China.
authors.forename: Aiguo
authors.initials: A
authors.lastname: Sha
authors.affiliation: Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China.
authors.forename: Dongmei
authors.initials: D
authors.lastname: Han
authors.affiliation: Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.affiliation: Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Geng
authors.affiliation: Reproductive Medicine Center, Affiliated Chenggong Hospital of Xiamen University, Xiamen, Fujian, People's Republic of China.
authors.forename: Chaihui
authors.initials: C
authors.lastname: Ma
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D010064:Embryo Implantation / Q000187:drug effects; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists* / Q000378:metabolism; D006785:Hospitals, University; D006801:Humans; D007246:Infertility / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction / Q000379:methods*; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin; D005300:Fertility Agents, Female; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone
keywords: Controlled ovarian hyperstimulation; gonadotropin releasing hormone agonist (GnRH-a); in vitro fertilization