BACKGROUND The addition of a GnRH analogue to the luteal phase in in vitro fertilization programs has been seldom proposed due to the presence of GnRH receptors in the endometrium. The aim of the study was to evaluate the effect of triptorelin addition in short antagonist cycles, compared to cycles where the only supplementation was progesterone. METHODS The primary objective of this study was the study of the effect of Triptorelin addiction during the luteal phase on the live birth rate. Secondary objectives of efficacy were pregnancy rates and implantation rates, as well as safety in terms of OHSS risks. The study was a prospective, randomized, open study, performed in two independent Centers from July 2013 to October 2015. Patients were divided into three groups: a) Regular antagonist protocol, with only luteal progesterone; b) Antagonist protocol with luteal triptorelin as multiple injections, c) Antagonist protocol with luteal triptorelin as single bolus. Descriptive statistics were obtained for all the parameters. Mean and standard deviation were used for all quantitative parameters. Differences between percentages were studied using Chi-square test generalized to the comparison of several proportions. RESULTS A total number of 1344 patients completed the study, 786 under the age of 35 years, and 558 over 35 years. It was observed an increase of positive HCG results, Clinical pregnancy rates and Delivery rates when triptorelin was added in the luteal phase, irrespective whether as a single bolus or five injections. This increase was statistically significant both for pregnancy rates and delivery rates. The statistic difference between pregnancies and deliveries obtained with or without luteal triptorelin reached p < 0,01. No increase of OHSS risk was observed. CONCLUSIONS From this large study it appears that the concept of luteal phase supplementation should be revisited. From our study it appears that triptorelin addition to the luteal phase of antagonist cycles, either as a single bolus or using multiple injections, is a good tool to optimize ART results. TRIAL REGISTRATION The study was approved by the Ethics Committee of Provincia di Bergamo (n 1203/2013).

中文翻译：

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在拮抗剂IVF周期中维持黄体期的GnRH激动剂：一项随机的前瞻性试验。

背景技术由于子宫内膜中存在GnRH受体，很少有人提出在体外受精程序中向黄体期添加GnRH类似物。这项研究的目的是评估曲普瑞林在短拮抗剂周期内的效果，与仅补充孕激素的周期相比。方法本研究的主要目的是研究黄体中曲普瑞林成瘾对活产率的影响。功效的次要目标是妊娠率和着床率，以及就OHSS风险而言的安全性。该研究是一项前瞻性，随机，开放性研究，于2013年7月至2015年10月在两个独立的中心进行。b）黄体曲普瑞林为多次注射的拮抗剂方案，c）黄体曲普瑞林为单次推注的拮抗剂方案。获得了所有参数的描述性统计量。所有定量参数均使用均值和标准差。使用卡方检验研究百分比之间的差异，该检验可推广到几个比例的比较。结果总共有1344名患者完成了研究，其中786名35岁以下的患者和558名35岁以上的患者。观察到在黄体期添加曲普瑞林时，无论是单次推注还是五次注射，HCG阳性结果，临床妊娠率和分娩率均增加。妊娠率和分娩率的增加均具有统计学意义。有或没有黄体曲普瑞林的妊娠与分娩之间的统计学差异达到p <0.01。没有观察到OHSS风险增加。结论从这项大的研究看来，黄体期补充的概念应该重新考虑。从我们的研究看来，将曲普瑞林添加到拮抗剂周期的黄体期，无论是单次推注还是多次注射，都是优化ART结果的良好工具。试验注册该研究已由Provincia di Bergamo伦理委员会批准（n 1203/2013）。从我们的研究看来，将曲普瑞林添加到拮抗剂周期的黄体期，无论是单次推注还是多次注射，都是优化ART结果的良好工具。试验注册该研究已由Provincia di Bergamo伦理委员会批准（n 1203/2013）。从我们的研究看来，将曲普瑞林添加到拮抗剂周期的黄体期，无论是单次推注还是多次注射，都是优化ART结果的良好工具。试验注册该研究得到了Provincia di Bergamo伦理委员会的批准（n 1203/2013）。