Evaluating the Impact of Long-Term GnRH Agonist Therapy on Pregnancy Outcomes in Endometriosis-Associated Implantation Failure and Pregnancy Loss

Masato Kobanawa
In: Journal of IVF-Worldwide · 2024 · vol. 2(1) · doi:10.46989/001c.115593 · W4393258354
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Long-term GnRH agonist therapy followed by HRT improved live birth rates in endometriosis patients with recurrent implantation failure or pregnancy loss compared to HRT alone.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective comparative study evaluated whether long-term depot GnRH agonist therapy (leuprolide acetate for 1–2 months for endometriosis symptom relief), followed by a thawed blastocyst transfer in an HRT cycle, improves pregnancy outcomes in 70 patients with clinically diagnosed endometriosis and a history of recurrent implantation failure or recurrent pregnancy loss, compared with HRT cycles without GnRH agonists. The GnRH agonist group had a significantly higher live birth rate than the control group (37.50% vs 13.04%), and multivariable logistic regression adjusting for age and gravidity supported this association (OR 15.3, p=0.005), while miscarriage and biochemical pregnancy outcomes and perinatal complications were assessed as key endpoints. A major limitation explicitly implied by the design is that it is non-randomized and retrospective, with small sample sizes and potential confounding despite statistical adjustment. This paper is centrally about endometriosis—specifically evaluating long-term GnRH agonist use in HRT thawed embryo transfer protocols for patients with endometriosis-associated recurrent implantation failure or recurrent pregnancy loss.

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Abstract

Purpose This study aimed to investigate the efficacy of long-term gonadotropin-releasing hormone (GnRH) agonist therapy in preventing endometriosis progression and relieving symptoms, particularly on pregnancy outcomes during thawed embryo transfer in patients experiencing endometriosis and recurrent implantation failure or recurrent pregnancy loss. Methods In individuals with clinical endometriosis and a history of recurrent implantation failure or recurrent pregnancy loss, we conducted a comparative analysis of clinical outcomes between those undergoing long-term GnRH agonist treatment for symptom relief, such as menstrual pain, followed by embryo transfer using Hormone Replacement Therapy (HRT) cycle, and those undergoing embryo transfer using an HRT cycle without GnRH agonist treatment. The study examined various clinical outcomes between the two groups. Results The primary outcomes included live birth rate (LBR), miscarriage rate, biochemical pregnancy rate, and perinatal complications. The GnRH agonist group showed significantly higher LBR than the control group (37.50% vs. 13.04%; p=0.02). Multivariable logistic regression analysis, adjusted for age and gravidity, showed significantly higher LBR in the GnRH agonist group compared to the control group (odds ratio: 15.3; 95% confidence interval: 2.30, 102.00; p=0.005). Conclusions The findings of this study suggested that employing a GnRH agonist in the embryo transfer protocol is effective for patients with endometriosis experiencing recurrent implantation failure or recurrent pregnancy loss.

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Condition tags

endometriosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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