Early-cleavage is a reliable predictor for embryo implantation in the GnRH agonist protocols but not in the GnRH antagonist protocols.

Full Abstract

BACKGROUND: To test if early-cleavage was a strong predictor of pregnancy in patients receiving either a GnRH agonist long protocol or a GnRH antagonist protocol for in-vitro fertilization treatment (IVF) and intracytoplasmic sperm injection (ICSI). METHODS: This retrospective study included 534 patients undergoing a fresh cycle of oocyte retrieval and the day-3 embryo transfer (from 22 to 46 years old). Of the 534 patients treated, 331 received a GnRH agonist long stimulation protocol (GnRH agonist group) for ovarian stimulation and 203 patients received a GnRH antagonist protocol (GnRH antagonist group). In each group, patients who had at least one early-cleavage embryo transferred were designated as the 'early-cleavage' subgroup. Patients who had no early-cleavage embryos transferred were designated as the 'late-cleavage' subgroup. RESULTS: The early cleavage rate was significantly lower in the GnRH antagonist group compared with that in the GnRH agonist group (IVF cycles: 34% versus 20%; ICSI cycles: 50% versus 37.8%, respectively, P < 0.0001). In the GnRH agonist group, the pregnancy rates were significantly higher in the early-cleavage subgroup than those in the late-cleavage subgroup (53.7% vs 33.9%, P < 0.0001). In the GnRH antagonist group, the pregnancy rates were not significantly different between the early-cleavage and late-cleavage subgroups (45.9% vs 43.8%, P > 0.05). CONCLUSION: Early cleavage of zygote is not a reliable predictor for embryo implantation potential in using the GnRH antagonist protocol. Furthermore, the implantation rates between the GnRH agonist and GnRH antagonist groups were comparable.

Author information

Author/s: Yang, Wen-Jui (WJ); Hwu, Yuh-Ming (YM); Lee, Robert Kuo-kuang (RK); Li, Sheng-Hsiang (SH); Fleming, Steven (S);

Affiliation: Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan. molinda11(-atsign-)yahoo.com.tw

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Reproductive biology and endocrinology : RB&E (Reprod Biol Endocrinol), published in England. (Language: eng)

Reference: 2009-; vol 7 (issue ) : pp 20

Dates: Created 2009/03/16; Completed 2009/07/22;

PMID: 19254386, status: MEDLINE (last retrieval date: 8/20/2009, IMS Date: )

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