Research Article| Volume 159, ISSUE 2, P355-358, December 2011

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Replacing GnRH agonists with GnRH antagonists in oocyte recipient cycle did not adversely affect the pregnancy rates


      The synchronization of the donor stimulation with the endometrial preparation of the recipient is usually done by downregulating the recipient's pituitary with a GnRH analog.


      The aim of this study is to compare pregnancy and implantation rates among premenopausal oocyte recipients synchronized by pituitary suppression with GnRH agonist (Group AGO) or antagonist (Group ANTAG) and standard endometrial preparation with estrogen and gestagen.

      Study design

      Prospective, observational, transversal, comparative study. Consecutive recipients treated at Institut Universitari Dexeus between July 2008 and December 2009.


      One hundred and eighty-three premenopausal women were included. No differences were found regarding the age of donors nor the age of recipients, fertilization rates, number of embryos transferred and embryo quality. No differences were found in clinical pregnancy rates (56.1% Group AGO vs. 52.4% Group ANTAG).


      The administration of GnRH antagonists during endometrial preparation in oocyte recipients facilitates synchronization without affecting the pregnancy rate.


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        • Lutjen P.
        • Trounson A.
        • Leeton J.
        • Findlay J.
        • Wood C.
        • Renou P.
        The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure.
        Nature. 1984; 307: 174-175
        • Martínez F.
        • Boada M.
        • Coroleu B.
        • et al.
        A prospective trial comparing oocyte donor ovarian response and recipient pregnancy rates between suppression with gonadotrophin-releasing hormone agonist (GnRHa) alone and dual suppression with a contraceptive vaginal ring and GnRH.
        Hum Reprod. 2006; 21: 2121-2125
        • Sauer M.V.
        Oocyte and embryo donation 2006: reviewing two decades of innovation and controversy.
        RBM Online. 2006; 12: 153-162
        • Martínez F.
        • Clua E.
        • Parera N.
        • Rodríguez I.
        • Boada M.
        • Coroleu B.
        Prospective, randomized, comparative study of leuprorelin + human menopausal gonadotropins versus ganirelix + recombinant follicle-stimulating hormone in oocyte donors and pregnancy rates among the corresponding recipients.
        Gynecol Endocrinol. 2008; 24: 188-193
        • Prapas N.
        • Prapas Y.
        • Panagiotidis Y.
        • et al.
        GnRH agonist versus GnRH antagonist in oocyte donation cycles: a prospective randomized study.
        Hum Reprod. 2005; 20: 1516-1520
        • Tarlatzis B.C.
        • Fauser B.C.
        • Kolibianakis E.M.
        • Diedrich K.
        • Rombauts L.
        • Devroey P.
        GnRH antagonists in ovarian stimulation for IVF.
        Hum Reprod Update. 2006; 12: 333-340
        • Bodri D.
        • Vernaeve V.
        • Guillén J.J.
        • Vidal R.
        • Figueras F.
        • Coll O.
        Comparison between a GnRH antagonist and a GnRH agonist flare-up protocol in oocyte donors: a randomized clinical trial.
        Hum Reprod. 2006; 21: 2246-2251
        • Martínez F.
        • Clua E.
        • Santmartí P.
        • Boada M.
        • Rodriguez I.
        • Coroleu B.
        Randomised, comparative pilot study of pituitary suppression with depot leuproreline vs Cetrorelix acetate 3 mg in gonadotropin stimulation protocols for oocyte donors.
        Fertil Steril. 2010; 94: 2433-2436
        • Galindo A.
        • Bodri D.
        • Guillén J.J.
        • Colodrón M.
        • Vernaeve V.
        • Coll O.
        Triggering with HCG or GnRH agonist in GnRH antagonist treated oocyte donation cycles: a randomised clinical trial.
        Gynecol Endocrinol. 2009; 25: 60-66
        • Bodri D.
        • Guillén J.J.
        • Trullenque M.
        • Schwenn K.
        • Esteve C.
        • Coll O.
        Early ovarian hyperstimulation syndrome is completely prevented by gonadotropin releasing-hormone agonist triggering in high-risk oocyte donor cycles: a prospective, luteal-phase follow-up study.
        Fertil Steril. 2010; 93: 2418-2420
        • Prapas N.
        • Tavaniotou A.
        • Panagiotidis Y.
        • et al.
        GnRH antagonists and endometrial receptivity in oocyte recipients: a prospective randomized trial.
        Reprod Biomed Online. 2009; 18: 276-281
        • Dal Prato L.
        • Borini A.
        • Cattoli M.
        • Bonu M.A.
        • Sciajno R.
        • Flamigni C.
        Endometrial preparation for frozen–thawed embryo transfer with or without pretreatment with gonadotropin-releasing hormone agonist.
        Fertil Steril. 2002; 77: 956-960
        • El-Toukhy T.
        • Taylor A.
        • Khalaf Y.
        • et al.
        Pituitary suppression in ultrasound-monitored frozen embryo replacement cycles. A randomised study.
        Hum Reprod. 2004; 19: 874-879
        • Ghobara T.
        • Vandekerckhove P.
        Cycle regimens for frozen–thawed embryo transfer.
        Cochrane Database Syst Rev. 2008; 23: CD003414
        • Hernandez E.R.
        Embryo implantation and GnRH antagonists: embryo implantation: the Rubicon for GnRH antagonists.
        Hum Reprod. 2000; 15 ([review]): 1211-1216
        • The Ganirelix Dose-finding Study Group
        A double-blind, randomized, dose-finding study to assess the efficacy of the gonadotrophin-releasing hormone antagonist ganirelix (Org 37462) to prevent premature luteinizing hormone surges in women undergoing ovarian stimulation with recombinant follicle stimulating hormone (Puregon).
        Hum Reprod. 1998; 13: 3023-3031
        • Kolibianakis E.
        • Bourgain C.
        • Albana C.
        • et al.
        Effect of ovarian stimulation with recombinant follicle-stimulating hormone, gonadotropin releasing hormone antagonists, and human chorionic gonadotropin on endometrial maturarion on the day of oocyte pick-up.
        Fertil Steril. 2002; 78: 1025-1029
        • Papanikolaou E.G.
        • Bourgain C.
        • Kolibianakis E.
        • Tournaye H.
        • Devroey P.
        Steroid receptor expression in late follicular phase endometrium in GnRH antagonist IVF cycles is already altered, indicating initiation of early luteal phase transformation in the absence of secretory changes.
        Hum Reprod. 2005; 20: 1541-1547
        • Rackow B.W.
        • Kliman H.J.
        • Taylor H.S.
        GnRH antagonists may affect endometrial receptivity.
        Fertil Steril. 2008; 89: 1234-1239
        • Simon C.
        • Oberyé J.
        • Bellver J.
        • et al.
        Similar endometrial development in oocyte donors treated with either high-or standard dose GnRH antagonist compared to treatment with a GnRH agonist or in natural cycles.
        Hum Reprod. 2005; 20: 3318-3327
        • Klemmt P.A.B.
        • Liu F.
        • Carver J.G.
        • et al.
        Effects of gonadotrophin releasing hormone analogues on human endometrial stromal cells and embryo invasion in vitro.
        Hum Reprod. 2009; 24: 2187-2192
        • Bodri D.
        • Guillén J.J.
        • Polo A.
        • Trullenque M.
        • Esteve C.
        • Coll O.
        Complications related to ovarian stimulation and oocyte retrieval in 4052 oocyte donor.
        RBM Online. 2008; 17: 237-243
        • Orvieto R.
        • Meltcer S.
        • Volodarski M.
        • et al.
        Luteal phase support for patients undergoing frozen–thawed embryo transfer cycles: the required progesterone dose.
        Clin Exp Obstet Gynecol. 2007; 34: 25-26