Abstract
Objective
Autoantibodies are associated with worse outcomes in vitro fertilization (IVF)/intracytoplasmic
sperm injection (ICSI), including increasing miscarriage rate, lowering pregnancy
rate, and lowering delivery rate. However, little is known about improving IVF/ICSI
outcomes for autoantibody-positive women, especially in frozen-thawed embryo transfer
(FET) cycles. This study aimed to investigate whether pituitary suppression before
FET improves the clinical pregnancy rate (CPR) and live birth rate (LBR) for IVF/ICSI
women positive for serum autoantibodies.
Study design
A total of 181 infertile women positive for serum autoantibodies were recruited, including
65 women receiving GnRHa and hormone replacement therapy protocols (G-HRT group) and
116 women using modified natural cycles (MNC)/mild stimulated cycles (MSC) as FET
protocols (MNC/MSC group). The outcomes were compared between two groups, including
CPR, implantation rate (IR), miscarriage rate (MR), ongoing pregnancy rate (OPR),
LBR, and gestational age (GA). The primary outcome of the study was CPR.
Results
CPR, OPR, and LBR per embryo transferred in the G-HRT groups were significantly higher
than those in the MNC/MSC group. No statistically significant differences were observed
in the IR and MR. The CPR, IR, MR, OPR, and LBR was 72.23%, 64.00%, 12.77%, 63.07%,
and 63.07% in the G-HRT group, respectively, while that was 56.90%, 53.07%, 10.60%,
50.00%, and 50.00% in the MNC/MSC group, respectively. After adjusting for partial
potential confounding factors using multiple logistic regression, the type of endometrial
preparation is the factor independently associated with enhanced CPR (OR = 0.48, 95%CI:
0.24–0.96, P = 0.039).
Conclusions
The current study showed that prior long-term GnRHa suppression could benefit patients
with high serum autoantibody levels during IVF/ICSI FET cycles.
Keywords
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Article info
Publication history
Published online: August 24, 2021
Accepted:
August 20,
2021
Received in revised form:
August 12,
2021
Received:
April 29,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
