Safety profiles of offspring born from early-follicular long-acting GnRH agonist protocol and daily mid-luteal GnRH agonist protocol: a retrospective study
- PMID: 38807043
- PMCID: PMC11134633
- DOI: 10.1186/s12884-024-06589-7
Safety profiles of offspring born from early-follicular long-acting GnRH agonist protocol and daily mid-luteal GnRH agonist protocol: a retrospective study
Abstract
Background: The gonadotropin hormone-releasing hormone agonists (GnRH-a) have been widely used for controlled ovarian stimulation in assisted reproductive technology (ART). The early-follicular long-acting GnRH-a long protocol (EFL) and the luteal phase short-acting GnRH-a long protocol (LPS) are commonly used GnRH agonist protocols. We conducted a retrospective analysis to assess and compare the rates of congenital abnormalities and safety profiles in offspring born from the EFL and LPS protocols.
Methods: We conducted a retrospective cohort study to analyze and compare neonatal data from patients who using EFL or LPS protocols at our center between January 1, 2014, and June 30, 2017. The study ultimately included 1810 neonates from 1401 cycles using the EFL protocol and 2700 neonates from 2129 cycles using the LPS protocol.The main outcome measures are gestational age at delivery, birth weight, and congenital anomaly rate.To assess the influence of various factors on congenital abnormalities, a random-effects logistic regression model was employed.
Results: The EFL and LPS protocols led to similar congenital anomaly rates (1.64% vs. 2.35%, P = 0.149). No significant differences were found between the two groups regarding birth weight and its categories, newborn gender and congenital anomaly rate. The results of the multivariate logistic regression model indicated no association between congenital anomaly and BMI, duration of infertility, treatment protocol, fertilization method, or embryo transfer stage. Compared with singleton pregnancies, the probability of congenital defects in multiple pregnancies was 2.64 times higher (OR: 2.64, 95% CI: 1.72-4.05, P < 0.0001). Newborns with congenital defects were born with a lower gestational age compared with full-term pregnancies.
Conclusion: In conclusion, the EFL protocol is considered a safe option for ensuring offspring safety, comparable with the LPS protocol; however, multiple pregnancies represent an independent risk factor for congenital abnormalities. This approach can be widely adopted; however, prioritizing single embryo transfers is strongly recommended to minimize the potential risks associated with multiple pregnancies in offspring.
Keywords: Assisted reproductive technology; Congenital anomaly; Early-follicular long-acting GnRH-a long protocol; Luteal phase short-acting GnRH-a long protocol; Neonatal outcomes.
© 2024. The Author(s).
Conflict of interest statement
The authors declare no competing interests.
Figures
![Fig. 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/11134633/bin/12884_2024_6589_Fig1_HTML.gif)
Similar articles
-
Is early-follicular long-acting GnRH agonist protocol an alternative for patients with polycystic ovary syndrome undergoing in vitro fertilization?Reprod Biol Endocrinol. 2022 Sep 10;20(1):137. doi: 10.1186/s12958-022-01007-z. Reprod Biol Endocrinol. 2022. PMID: 36088329 Free PMC article.
-
Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women: secondary outcome of an RCT comparing GnRH-antagonist and GnRH-agonist protocols.Hum Reprod. 2017 Mar 1;32(3):556-567. doi: 10.1093/humrep/dew358. Hum Reprod. 2017. PMID: 28130435 Clinical Trial.
-
Comparison of live-birth defects after luteal-phase ovarian stimulation vs. conventional ovarian stimulation for in vitro fertilization and vitrified embryo transfer cycles.Fertil Steril. 2015 May;103(5):1194-1201.e2. doi: 10.1016/j.fertnstert.2015.02.020. Epub 2015 Mar 23. Fertil Steril. 2015. PMID: 25813280
-
Gonadotropin-releasing hormone agonist versus HCG for oocyte triggering in antagonist-assisted reproductive technology.Cochrane Database Syst Rev. 2014 Oct 31;2014(10):CD008046. doi: 10.1002/14651858.CD008046.pub4. Cochrane Database Syst Rev. 2014. PMID: 25358904 Free PMC article. Review.
-
Gonadotrophin-releasing hormone antagonists for assisted conception.Cochrane Database Syst Rev. 2001;(4):CD001750. doi: 10.1002/14651858.CD001750. Cochrane Database Syst Rev. 2001. Update in: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD001750. doi: 10.1002/14651858.CD001750.pub2. PMID: 11687120 Updated. Review.
References
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources