Objective: To compare the influence of dual suppression with the use of GnRH agonist plus aromatase inhibitor compared with suppression with the use of GnRH agonist alone or no suppression at all in patients with idiopathic recurrent implantation failure (RIF).
Design: Retrospective cohort study.
Setting: University-affiliated reproductive center.
Patient(s): A total of 523 infertile women who failed two blastocyst transfers underwent a third frozen blastocyst transfer. Women with known endometriosis were excluded.
Intervention(s): A total of 204 subjects were not pretreated, 143 received 2 months of GnRH agonist (3.75 mg intramuscular leuprolide acetate monthly) only, and 176 received GnRH agonist and aromatase inhibitor (5 mg oral letrozole daily for 60 days). Demographic and stimulation information was collected and cycle outcomes reported.
Main Outcome Measure(s): Clinical pregnancy rates.
Result(s): Age, antral follicle count, basal FSH levels, duration of infertility, previous pregnancies, and full-term deliveries were similar (P>.05). Clinical pregnancy rates were higher among women who received GnRH agonist plus letrozole compared with women who received GnRH agonist only or women without pretreatment (63%, 42%, and 40%, respectively; P<.0001). Live birth rates were higher among women who received GnRH agonist plus letrozole compared with the other groups (56%, 36%, and 34%; P<.0001). No differences in pregnancy outcomes were noted between patients who did not receive pretreatment and those in the GnRH agonist only group.
Conclusion(s): In patients with RIF, treatment with a GnRH agonist plus letrozole may improve live birth rates in subsequent cycles. We hypothesize that this improvement is due to alterations in the endometrium receptivity or treatment of undiagnosed endometriosis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.fertnstert.2019.03.021 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Weighing up GnRH agonist therapy for endometriosis: outcomes and the treatment paradigm.
Expert Opin Pharmacother
January 2025
Obstetrics and Gynecology Department Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Introduction: Endometriosis is a chronic inflammatory estrogen-dependent disease affecting 10% of women worldwide leading to chronic pelvic pain and infertility which may be treated clinically or surgically.
Areas Covered: Current literaure was reviewed using the keywords 'gonadotropin releasing hormone agonists (GnRHa),' 'endometriosis,' 'infertility' and 'chronic pelvic pain.' Relevant papers prioritizing randomized controlled clinical trials (RCT), systematic reviews, meta-analyses, as well as international guidelines were evaluated.
GnRH Peptide Antagonist: Comparative Analysis of Chemistry and Formulation with Implications for Clinical Safety and Efficacy.
Pharmaceuticals (Basel)
December 2024
College of Pharmacy, University of Illinois, Chicago, IL 60612, USA.
Overexpression of the gonadotropin-releasing hormone receptor (GnRH-R) plays a vital role in the advancement of reproductive malignancies such as ovarian, endometrial, and prostate cancer. Peptidomimetic GnRH antagonists are a substantial therapeutic development, providing fast and reversible suppression of gonadotropins by directly blocking GnRH-R. Unlike typical GnRH agonists, these antagonists prevent the early hormonal flare, have a faster onset of action, and have a lower risk of cardiovascular problems.
View Article and Find Full Text PDFAggressive angiomyxoma of the vagina: A case report and literature review.
Medicine (Baltimore)
January 2025
Department of Internal Medicine, Division of Hematology and Oncology, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Rationale: Aggressive angiomyxoma (AAM) is an exceptionally rare mesenchymal tumor that predominantly manifests in the female genital organs during the reproductive age. Its rarity alone makes it a fascinating subject for study. The diagnosis of AAM necessitates differentiation from other benign or mesenchymal tumors and can be confirmed through immunohistochemistry (IHC) staining.
View Article and Find Full Text PDFSPATIAL MEMORY RECOVERY IN AGED MALE RATS TREATED WITH LEUPROLIDE ACETATE, A GNRH AGONIST.
Acta Endocrinol (Buchar)
January 2025
Universidad Autónoma de Aguascalientes, Centro de Ciencias Básicas, Department of Physiology and Pharmacology.
Context: Studies indicate a decrease in spatial memory across species as they age. Moreover, consistent administration of Gonadotropin-releasing hormone (GnRH) improves learning abilities in older rats that have undergone gonadectomy.
Objective: The aim of this study was to investigate the effects of the GnRH agonist, leuprolide acetate (LA) on spatial memory in aged intact male rats and the expression of proteins associated with hippocampal plasticity.
Triggering final follicular maturation for IVF cycles.
Reprod Biol Endocrinol
January 2025
Infertility and IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center (Tel Hashomer), Ramat Gan, 52621, Israel.
As part of a conventional controlled ovarian hyperstimulation (COH) regimen, final follicular maturation is usually triggered by a single bolus dose of human chorionic gonadotropin (hCG). COH, which combines GnRH antagonist co-treatment with GnRH agonist(GnRHa) trigger, is often used in attempts to eliminate severe early ovarian hyperstimulation syndrome and to improve oocyte/embryo yield and quality. Recently, the combination of GnRHa, with hCG trigger has also been implemented into clinical practice.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!