AUTHOR=Benmachiche Abdelhamid , Benbouhedja Sebti , Zoghmar Abdelali , Boularak Amel , Humaidan Peter 

TITLE=Impact of Mid-Luteal Phase GnRH Agonist Administration on Reproductive Outcomes in GnRH Agonist-Triggered Cycles: A Randomized Controlled Trial

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2017.00124

DOI=10.3389/fendo.2017.00124

ISSN=1664-2392

ABSTRACT=Objective: To explore whether the addition of a mid-luteal bolus of GnRH agonist (GnRHa) improves the implantation rate in IVF cycles. Design: A randomized controlled trial. Setting: Private IVF center. Patients: 328 IVF/ICSI patients were triggered with GnRHa and received 1.500 IU HCG on the day of oocyte pick-up (OPU) in addition to standard luteal phase support (LPS). Intervention(s): In addition, the study group received a bolus of GnRHa 6 days after OPU, whereas the control group did not. Main outcome Measure: Implantation rate (IR). Secondary outcome Measure(s): Ongoing pregnancy (OP) and live birth (LB) rates. Results: Although, serum concentrations of FSH, LH, E2 and P on day OPU+7 were significantly higher in the study group compared to the control group, the IR, was not statistically different between the treatment group (27%) and the control group (23%) [OR. 1.2 (95% CI 0.9–1.7), P< .27] Similarly, the OP rate, was 37% in the treatment group and 31% in the control group [OR.1.3 (95% CI 0.8–2.0), P< .23]. The LB rate, was 36% in the treatment group and 31% in the control group [OR:1.3 (95% CI 0.8–2.0), P< .27]. 
Conclusion(s): Although a trend toward a higher IR and pregnancy rate was observed in the treatment group, this difference was not statistically significant. However, the absolute risk difference of 5% found for LB is clinically relevant, and warrants further investigation.
NCT: 02053779
Keywords: GnRHa trigger, IVF, Luteal Phase Support, Luteal GnRHa, Mid-luteal steroids.