title: Addition of gonadotropin releasing hormone agonist for luteal phase support in in-vitro fertilization: an analysis of 2739 cycles.
abstract: OBJECTIVE
  Luteal phase is defective in in vitro fertilization (IVF) cycles, and many regimens were tried for the very best luteal phase support (LPS). Gonadotropin releasing hormone (GnRH) agonist use, which was administered as an adjunct to the luteal phase support in IVF cycles, was suggested to improve pregnancy outcome measures in certain randomized studies. We analyzed the effects of addition of GnRH agonist to standard progesterone luteal support on pregnancy outcome measures, particularly the live birth rates.
  
  
  METHODS
  This is a retrospective cohort study, including 2739 IVF cycles. Long GnRH agonist and antagonist stimulation IVF cycles with cleavage-stage embryo transfer were included. Cycles were divided into two groups: Group A included cycles with single-dose GnRH agonist plus progesterone LPS and Group B included progesterone only LPS. Live birth rates were the primary outcome measures of the analysis. Miscarriage rates and multiple pregnancy rates were the secondary outcome measures.
  
  
  RESULTS
  Live birth rates were not statistically different in GnRH agonist plus progesterone (Group A) and progesterone only (Group B) groups in both the long agonist and antagonist stimulation arms (40.8%/41.2% and 32.8%/34.4%, p<0.05 respectively). Moreover, pregnancy rates, implantation rates, and miscarriage rates were found to be similar between groups. Multiple pregnancy rates in antagonist cycles were significantly higher in Group A than those in Group B (12.0% and 6.9%, respectively).
  
  
  CONCLUSIONS
  A beneficial effect of a single dose of GnRH agonist administration as a luteal phase supporting agent is yet to be determined because of the wide heterogeneity of data present in literature. Well-designed randomized clinical studies are required to clarify any effect of luteal GnRH agonist addition on pregnancy outcome measures with different doses, timing, and administration routes of GnRH agonists.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF Unit, Başkent University Faculty of Medicine Adana Hospital, Adana, Turkey.
authors.forename: Erhan
authors.initials: E
authors.lastname: Şimşek
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF Unit, Başkent University Faculty of Medicine Adana Hospital, Adana, Turkey.
authors.forename: Esra Bulgan
authors.initials: EB
authors.lastname: Kılıçdağ
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF Unit, Başkent University Faculty of Medicine Adana Hospital, Adana, Turkey.
authors.forename: Pınar Çağlar
authors.initials: PÇ
authors.lastname: Aytaç
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF Unit, Başkent University Faculty of Medicine Adana Hospital, Adana, Turkey.
authors.forename: Gonca
authors.initials: G
authors.lastname: Çoban
authors.affiliation: Department of Obstetrics and Gynecology, Adana Maternity Hospital, Adana, Turkey.
authors.forename: Seda Yüksel
authors.initials: SY
authors.lastname: Şimşek
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF Unit, Başkent University Faculty of Medicine Adana Hospital, Adana, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Çok
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and IVF Unit, Başkent University Faculty of Medicine Adana Hospital, Adana, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Haydardedeoğlu
keywords: GnRH agonist; in vitro fertilization (IVF); luteal phase support; progesterone