The Influence Of Gonadotropin Releasing Hormone Agonist On Pregnancy Outcomes In Frozen-thawed Embryo Transfer Cycles For Patients With Endometriosis

Objective: To investigate the influence of gonadotropin releasing hormone agonist(Gn RH-a) on pregnancy outcomes in frozen-thawed embryo transfer cycles(FET) for endometriosis patients and the underlying factors to evaluate the effectiveness or to predict pregnancy outcome.Methods:(1)287 frozen-thawed embryo transfer cycles of endometriosis patients combined with infertility in reproductive medicine center, the first affiliated hospital of Anhui medical university were enrolled in retrospective analysis. All cycles were divided into 2 groups including treated group and control group according to whether treated by Gn RH-a or not. The outcomes and indexes were compared in the 2 groups.(2)110 frozen-thawed embryo transfer cycles of endometriosis patients combined with infertility in reproductive medicine center, the first affiliated hospital of Anhui Medical University were enrolled in the study. All transfer cycles were divided into two groups including Gn RH-a group and control group. The treatment of Gn RH-a was given before FET in the cycles of Gn RH-a group and the treatment was not given in the cycles of control group. The outcomes, serum indexes and ultrasonic indexes were compared between the two groups. The cycles were divided into two parts, which were natural FET cycles(NC) and artificial FET cycles(AC), according to the program of endometrial preparation. To compare the indexes in both parts. The influence factors of pregnancy outcomes were explored using univariate analysis and multivariate analysis.Results:(1)The clinical pregnancy rate(55.56%) and the implantation rate(33.33%) in the treated group was significantly higher than that in the control group(35.03% and 18.37%).(2)There were no significant differences in age, years of infertility, body mass index(BMI) between two groups. The clinical pregnancy rate(63.64%) and the implantation rate(44.04%) in the Gn RH-a group was significantly higher than that in the control group(41.82% and 28.57%). In the NC subgroup, the clinical pregnancy rate(73.91%)in the Gn RH-a group was significantly higher than that in the control group(46.67%), too. Besides, the indexes including serum CA125, PP14, E2 and P levels in the Gn RH-a group were significantly lower than those in the control group. Univariate and multivariate analysis showed that Gn RH-a was a protective factor of pregnancy outcome.Conclusions: Gn RH-a has a protective effect on pregnancy outcomes in frozen-thawed embryo transfer cycles for patients of endometriosis combined with infertility. In natural FET cycles, the levels of serum CA125 and PP14 are underlying factors to evaluate the effectiveness of Gn RH-a and the level of serum CA125 is underlying indicators to predict the outcome of FET cycles.