[Impact of gonadotropin-releasing hormone agonist on pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure combined with chronic endometritis].

Abstract

Objective: To explore the impact of gonadotropin-releasing hormone agonist (GnRH-a) on the pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure (RIF) complicated by chronic endometriti (CE). Methods: A total of 138 patients with RIF combined with CE who underwent in vitro fertilization/intracytoplamic sperm injection treatment-embryo transfer in the Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to December 2023 were retrospectively included. According to the endometrial preparation protocol, they were divided into two groups: the pituitary downregulation group (n=59) and the artificial cycle group (n=79). The baseline data and pregnancy outcomes of the two groups were compared. Multivariate binary logistic regression analysis was conducted to assess the influencing factors of clinical pregnancy in patients with RIF complicated by CE. Results: The age of the artificial cycle group [M(Q₁, Q₃)] was 33(31, 37) years; the age of pituitary downregulation was 33(30, 36) years. No statistically significant differences were found in the baseline data of the patients, such as age, the type of infertility, duration of infertility, body mass index (BMI), anti-Müllerian hormone (AMH), and baseline endocrine parameters(all P>0.05). For patients with RIF combined with CE, compared to the artificial cycle group, the pituitary downregulation group had a higher number of previous failed attempts [M(Q₁, Q₃), 3(3, 4) vs 4(3, 4) ], and a higher clinical pregnancy rate[42.37% (25/59) vs 24.05% (19/79)](P<0.05). GnRH-a pretreatment in a pituitary downregulation cycle is a factor influencing clinical pregnancy in patients with RIF combined with CE (OR=2.229, 95%CI: 1.015-4.896, P<0.05). Conclusion: GnRH-a is effective in improving the clinical pregnancy rate of patients with RIF combined with CE.