2012년 미국불임학회 (ASRM) P-264 Beneficial effects of GnRH agonist in luteal phase: Age-dependent difference. (황체기 보강에서 GnRH 효능제가 나이에 따라 어떤 좋은 이점을 보이는가?)

Il Hae Park, M.D.1, K.H. Lee1, H.G. Sun1, S.G. Kim1, Y.Y. Kim1 and Gyun-Ho Jeon2.
1 Mamapapa & baby OB&GY, 1367-5 Hwashin building 4th floor Dal-dong, Nam-gu Ulsan, X, Republic of Korea, 680-805
2 OBGY, Inje University, Haeundae Paik Hospital, Haeundaero 875, Haeundae-Gu Busan, X, Republic of Korea, 612-030.

OBJECTIVE

Several schemes of luteal phase support (LPS) have been used to increase the chance of pregnancy in controlled ovarian hyperstimulation (COH) IVF cycles. Administration of GnRH agonist has been recently suggested as an alternative for LPS. The purpose of this study is to assess the effects of GnRH agonist addition as a luteal phase support protocol in different age groups.

DESIGN

A retrospective study

MATERIALS AND METHODS

We retrospectively reviewed 489 patients undergoing IVF from April 2011 to February 2012. Women received routine luteal phase support (progesterone only) or GnRH agonist(a single 0.5mg dose of leuporide 6 days after oocyte aspiration) in addition to progesterone. Two groups of patients were formed based on LPS protocols. Group I (conventional LPS group) consisted of patients who received only progesterone. Group II (GnRH agonist addition group) consisted of patients who received progesterone and GnRH agonist. IVF outcomes of two groups were compared in young-age (<35 years) patients and old-age (≥ 35 years) patients.

RESULTS

Age, the number of oocytes, 2PNs, transferred embryos weresimilar between two groups. Pregnancy rate of Group II showed a tendency to increase than that of Group I, but did not show statistical significance [48.9%(111/227) vs. 44.3%(116/262), P=0.07]. In young-age patients (age < 35 years old), Group II had similar pregnancy rates with Group I [58.3%(67/115) vs. 57.1%(84/147), P=0.25]. In old-age patients (age≥ 35 years), Group II had significantly higher pregnancy rates than group I [39.3%(44/112) vs. 27.8%(32/115), P=0.028].

CONCLUSION

Administration of single-dose GnRH agonist in addition to standard luteal support seems to be more effective in old age patients than young age patients. It is probably because luteal phase defect is more common in women as they get older. In this reason, many clinicians give more intensive LPS to old age patients. Therefore, GnRH agonist addition could be a good alternative in old age patients who need more secure LPS.