Perinatal outcomes in 521 gestations after fresh and frozen cycles: a secondary outcome of a randomized controlled trial comparing GnRH antagonist versus GnRH agonist protocols.
Adult
Birth Weight
/ physiology
Cryopreservation
Embryo Transfer
/ methods
Embryo, Mammalian
Female
Fertility Agents, Female
/ therapeutic use
Follow-Up Studies
Freezing
Gonadotropin-Releasing Hormone
/ agonists
Hormone Antagonists
/ therapeutic use
Humans
Infant, Newborn
Male
Ovulation Induction
/ methods
Pregnancy
Pregnancy Outcome
/ epidemiology
ART
GnRH agonist
GnRH antagonist
Perinatal outcomes
Journal
Reproductive biomedicine online
ISSN: 1472-6491
Titre abrégé: Reprod Biomed Online
Pays: Netherlands
ID NLM: 101122473
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
03
04
2019
revised:
05
05
2019
accepted:
14
05
2019
pubmed:
15
8
2019
medline:
21
8
2020
entrez:
15
8
2019
Statut:
ppublish
Résumé
Are perinatal outcomes different after treatment with the gonadotrophin-releasing hormone (GnRH) antagonist versus the long GnRH agonist protocol for IVF? Perinatal outcomes were secondary outcomes in a large Phase IV, dual-centre, open-label, randomized controlled trial to compare GnRH antagonist and long GnRH agonist protocols in women <40 years undergoing their first assisted reproductive technology treatment. Women (n = 1050) were randomized in a ratio 1:1 from January 2009 to December 2013 and followed until December 2016. All fresh and frozen embryo transfer (FET) cycles from a single oocyte aspiration, resulting in a gestation (human chorionic gonadotrophin >10 IU/l) were included (n = 521). Data were analysed to compare preterm birth [PTB] (<37 weeks), very PTB (<32 weeks), low birthweight [LBW] (<2500 g) and very LBW (<1500 g) rates among singleton live births in GnRH antagonist versus agonist protocol. Similar perinatal outcomes were found after both protocols. In singletons after fresh embryo transfer, mean gestational age at delivery was 39.1 ± 2.49 versus 39.3 ± 1.90 (P = 0.67) and very PTB rates 1.9% versus 0% (P = 0.17). Mean birthweight was 3264 ± 662 g in the antagonist and 3341 ± 562 g in the agonist group (P = 0.37). LBW was found in 12.4% versus 7% (P = 0.19) and very LBW in 2.9% versus 1% (P = 0.34). In FET cycles, the perinatal outcomes were similar. Small for gestational age and large for gestational age rates were similar in both protocols for singleton live births after fresh and FET. Perinatal outcomes are similar after the GnRH antagonist versus GnRH agonist protocols for IVF. The choice of the GnRH analogue in ovarian stimulation should be based solely on optimizing the chance of pregnancy and not on risks in perinatal outcomes.
Identifiants
pubmed: 31409522
pii: S1472-6483(19)30548-6
doi: 10.1016/j.rbmo.2019.05.010
pii:
doi:
Substances chimiques
Fertility Agents, Female
0
Hormone Antagonists
0
Gonadotropin-Releasing Hormone
33515-09-2
Types de publication
Clinical Trial, Phase IV
Journal Article
Multicenter Study
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
659-664Informations de copyright
Copyright © 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.