Purpose: Gonadotrophin releasing hormone agonist (GnRH-a) is widely used for pituitary down-regulation and recruiting more follicles in assisted reproduction. However, no information is available on its value for patients with thin endometrial thickness.
Patients and Methods: This was a retrospective cohort study of 302 patients with endometrium < 8 mm undergoing fresh embryo transfer at a fertility center of a university hospital from January 2016 and December 2018. In 148 cycles of the GnRH-a prolonged protocol, one depot of 3.75 mg GnRH-a was injected on day 2 of the menstrual cycle, while in 154 cycles of the short GnRH-a long protocol, 0.1 mg of GnRH-a was injected daily from the mid-luteal phase. The live birth rate and clinical pregnancy rate were compared between the two groups. Other outcome measures included the implantation rate, miscarriage rate, and characteristics of stimulation procedures.
Results: Live birth rates and clinical pregnancy rates were significantly higher in the GnRH-a prolonged protocol group than in the other group (36.5% vs 20.8%, P=0.002; 43.9% vs 28.2%, P=0.006, respectively). The live birth rate was significantly increased in the prolonged protocol group (crude OR: 2.190, 95% CI: 1.311, 3.660; adjusted OR: 2.458, 95% CI: 1.430, 4.224) compared with that in the reference group. The implantation rate of the former group was also significantly higher than that of the latter group (35.4% vs 15.9%, P=0.000). There was no significant difference in miscarriage rates between the two protocols. In terms of stimulation procedures, the GnRH-a prolonged protocol group required significantly higher Gn time (10.9 vs 9.5 days, P=0.000) and Gn consumption (2625.0 vs 2047.5 IU, P=0.000) than the short GnRH-a long protocol group.
Conclusion: The GnRH-a prolonged protocol in fresh embryo transfer cycles yielded better clinical outcomes of patients with thin endometrium than the short GnRH-a long protocol.

Keywords: ovarian stimulation, GnRH-a prolonged protocol, thin endometrium, IVF, COH


中文翻译：

---

GnRH-a 延长方案和短 GnRH-a 长方案在薄子宫内膜患者辅助生殖中的比较：一项回顾性队列研究

目的：促性腺激素释放激素激动剂（GnRH-a）广泛用于辅助生殖中垂体的下调和募集更多的卵泡。然而，没有关于其对子宫内膜厚度薄的患者的价值的信息。
患者和方法：这是一项回顾性队列研究，对 2016 年 1 月至 2018 年 12 月在一所大学医院的生育中心接受新鲜胚胎移植的 302 名子宫内膜 < 8 mm 的患者进行了一项回顾性队列研究。在 148 个周期的 GnRH-a 延长方案中，一个仓库 3.75 mg GnRH -a 在月经周期的第 2 天注射，而在短 GnRH-a 长方案的 154 个周期中，从黄体中期开始每天注射 0.1 mg GnRH-a。比较两组的活产率和临床妊娠率。其他结果测量包括植入率、流产率和刺激程序的特征。
结果： GnRH-a 延长方案组的活产率和临床妊娠率显着高于另一组（36.5% vs 20.8%，P=0.002; 分别为43.9% 和 28.2%，P = 0.006）。与参考组相比，延长方案组的活产率显着增加（粗 OR：2.190、95% CI：1.311、3.660；调整后的 OR：2.458、95% CI：1.430、4.224）。前组植入率也显着高于后组（35.4% vs 15.9%，P =0.000）。两种方案的流产率没有显着差异。在刺激程序方面，与短 GnRH-a 长方案组相比，GnRH-a 延长方案组需要显着更高的 Gn 时间（10.9 对 9.5 天， P = 0.000）和 Gn 消耗（2625.0 对 2047.5 IU，P = 0.000） .
结论：在新鲜胚胎移植周期中，GnRH-a 延长方案比短 GnRH-a 长方案对子宫内膜薄的患者产生了更好的临床结果。

关键词：卵巢刺激，GnRH-a 延长方案，薄子宫内膜，IVF，COH