Contribution to More Patient-Friendly ART Treatment: Efficacy of Continuous Low-Dose GnRH Agonist as the Only Luteal Support—Results of a Prospective, Randomized, Comparative Study

Table 4

Main characteristics of trials on the use of multiple doses of GnRH agonist for luteal phase support.

Trial	Study; design	Stimulation protocol	Ovulation trigger	Luteal phase support			Day of ET	Implantation rate (study group/control group)	(Ong/Clin) Pregnancy rate (study group/control group)
				Study group; GnRH-a	Control group	Other concomitant medications; (all patients)
Fujii et al. [5]	RCT	GnRH-a long	5.000 IU u-hCG	: 161; Continuous 600 µg/d IN buserelin twice daily during the luteal phase until D14 after OPU	: 158; No placebo	Dydrogesterone for 14 days (10 mg/d) + i.m. hCG on the day of ET (2.500 IU)	Days 2-3	28.5%; 19.6% ()	Clin PR: 44.5%; 34.3%; (NS)
Pirard; et al. [15]	RCT (dose finding study)	GnRH-antag	IN buserelin (study groups); 10.000 u-hCG (control group)	IN buserelin during the luteal phase until D14 after OPU; 1 every 2 d (: 2); 1/d (: 3); 2/d (: 6); 3/d (: 6)	: 6; Vaginal micronized progesterone (600 mg/d)	No other drug (for study groups)	Day 3	NA	NA
Hugues et al. [18]	ESHRE abstract	GnRH-antag	250 µg r-hCG	: 25; 0.1 mg/triptorelin; Two injections (D3 and D6 after OPU)	: 22; No placebo	Vaginal micronized progesterone (400 mg/day)	Day 3	NA	NA
Isikoglu et al. [19]	RCT	GnRH-a long	10.000 IU u-hCG	: 90; Continuous 0.25 mg/d leuprolide acetate during the luteal phase until 14 days after OPU	: 91; No placebo	i.m. progesterone (50 g/day)	NA	35.6%; 35.3%; (NS)	Clin PR: 50.0%; 52.32%; (NS)
Qublah et al. [9]	RCT	GnRH-a long	10.000 IU u-hCG	: 60; 0.1 mg/triptorelin; Three injections (D of OPU, D3, and D6 after OPU)	: 60; Placebo	Vaginal progesterone (pessaries: cyclogest)	Day 3	21.4%; 7.3%; ()	PR: 36.6%; 13.3%; ()
Inamdar and Majumdar [12]	RCT	GnRH-a long	250 µg r-hCG	: 213; 1 mg/leuprolide acetate; Three injections (D6, D7, and D8 after OPU)	: 213; No placebo	Vaginal progesterone (400 mg twice daily) alternating with i.m. natural micronized progesterone (100 mg) starting from the day of OPU	Day 2	17.57%; 17.07%; (NS)	Ong PR: 27.69%; 26.29%; (NS)
Yıldız; et al. [14]	RCT	GnRH-a long	10.000 IU u-hCG	: 84; 1 mg/leuprolide acetate; Two injections D6 and D9 after OPU	: 95; No placebo	Vaginal micronized progesterone (600 mg/d) + 17β estradiol (4 mg/d)	Day 3	25.8%; 13.3%; (NS)	Ong PR: 42.9%; 27.4%; (NS)

d: day; ET: embryo transfer; GnRH-a: GnRH agonist; GnRH-antag: GnRH antagonist; IU: international unit; : number of cycles; OPU: oocyte pick-up; r: recombinant; u: urinary; PR: pregnancy rate; Clin PR: clinical pregnancy rate; Ong PR: ongoing pregnancy rate; NA: not available; NS: not significant.