Peer Review #1 of "Prolonged pituitary down-regulation with full-dose of gonadotropin-releasing hormone agonist in different menstrual cycles: a retrospective cohort study (v0.1)"

2019 · doi:10.7287/peerj.6837v0.1/reviews/1 · W4244699635
peer-review OA: gold CC0
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Abstract

Background:The efficiency of prolonged down-regulation caused by a full-dose of gonadotropin-releasing hormone agonist (GnRH-a) injected during different menstrual phases has not yet been researched.Our goal was to evaluate the effects of GnRH-a, which was used in different phases of the menstrual cycle in patients undergoing in vitro fertilization and embryo transfer (IVF-ET).Methods: This was a retrospective cohort study.Three hundred and twenty patients received a prolonged pituitary down-regulated fulldose (3.75mg) of triptorelin in the early follicular phase, and 160 patients received the same full-dose of triptorelin during the mid-luteal phase.Clinical and laboratory outcomes were compared between the two groups.Results: The basic characteristics of the two groups were comparable.The mean number of retrieved oocytes, fertilized oocytes, cleavage oocytes and good quality embryos were comparable between the two groups.Although there was a higher antral follicle count (AFC), cyst formation rate, fertilization rate and cleavage rate in the follicular phase group, no statistically significant effects were seen on implantation rate (41.15% vs. 45.91%),clinical pregnancy rate (60.38% vs. 61.36%),ongoing pregnancy rate (57.74% vs. 57.58%),live birth rate (56.23% vs. 57.58%)or early abortion rate (2.64% vs. 3.79%) per fresh transfer cycle.Moreover, severe ovarian hyper-stimulation syndrome (OHSS) rates at the early stage (1.89% vs. 2.27%) were low in both groups.Conclusions: Prolonged pituitary down-regulation achieved by utilizing a full-dose of GnRH-a administrated in either phase of the menstrual cycle can have a positive effect on ongoing pregnancy rate and live-birth rate per fresh embryo transfer cycle.Ovarian cyst formation rate was higher in the follicular phase group, but this did not have any adverse impact on clinical results.

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