title: Gonadotropin-releasing hormone analogue as sole luteal support in antagonist-based assisted reproductive technology cycles.
abstract: To evaluate the efficacy of GnRH agonists (GnRH-a) as sole luteal phase support in patients undergoing IVF in antagonist-based cycles compared with standard vaginal P preparations.
  
  
  
  Retrospective cohort.
  
  
  
  Private fertility clinic.
  
  
  
  Patients who underwent antagonist-based cycles performed at our clinic between 2009 and 2015.
  
  
  
  Intranasal GnRH-a or vaginal P as luteal support.
  
  
  
  Live birth rates.
  
  
  
  A total of 2,529 antagonist-based cycles from 1,479 women were available for analysis, in which GnRH-a were used in 1,436 cycles (56.7%) and P supplementation in 1,093 cycles (43.2%). Significantly higher live birth rates were demonstrated for the entire GnRH-a group compared with the P group. This result was even more prominent when women older than 35 years were considered separately. Furthermore, after adjustment for age, body mass index (BMI), past obstetric history, number of IVF cycles, oocyte retrieved and embryos transferred, GnRH-a was still associated with a higher rate of live birth (odds ratio 1.46, 95% confidence interval 1.10-1.94). Once a positive β-hCG was achieved, chemical pregnancy rates (PRs) and miscarriage rates were not statistically different between the GnRH-a and the P supplementation group, and GnRH-a was associated with a higher rate of live births (odds ratio 1.59, 95% confidence interval 1.07-2.36).
  
  
  
  This large retrospective study suggests that repeated intranasal GnRH-a for luteal phase support is associated with a higher live birth rate compared with standard P supplementations.
authors.affiliation: The Fertility Center from A to Z, Assuta Medical Centre, Ramat Aviv, Tel-Aviv, Israel.
authors.forename: Itai
authors.initials: I
authors.lastname: Bar Hava
authors.affiliation: Naveen Jindal School of Management, University of Texas at Dallas, Dallas, Texas.
authors.forename: Moran
authors.initials: M
authors.lastname: Blueshtein
authors.affiliation: The Fertility Center from A to Z, Assuta Medical Centre, Ramat Aviv, Tel-Aviv, Israel. Electronic address: hadassganer@yahoo.com.
authors.forename: Hadas
authors.initials: H
authors.lastname: Ganer Herman
authors.affiliation: The Fertility Center from A to Z, Assuta Medical Centre, Ramat Aviv, Tel-Aviv, Israel.
authors.forename: Yeela
authors.initials: Y
authors.lastname: Omer
authors.affiliation: The Fertility Center from A to Z, Assuta Medical Centre, Ramat Aviv, Tel-Aviv, Israel.
authors.forename: Gila
authors.initials: G
authors.lastname: Ben David
mesh_terms: D000281:Administration, Intranasal; D000282:Administration, Intravaginal; D000328:Adult; D016009:Chi-Square Distribution; D005260:Female; D005298:Fertility / Q000187:drug effects; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000009:adverse effects; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000009:adverse effects / Q000032:analysis; D006801:Humans; D007246:Infertility / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050498:Live Birth; D016015:Logistic Models; D008183:Luteal Phase / Q000187:drug effects*; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D018873:Pregnancy Rate; D011374:Progesterone / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D011374:Progesterone
keywords: GnRH analogue; in vitro fertilization (IVF); live birth rate; luteal phase support; pregnancy