Min Xu,* Honglin Li,* Yiyan Zhao, Huimei Li, Chao Zhao, Xi Zhang, Rong Ni, Jian Liang, Jinhuan Xu

Reproductive Center, Huai’an First People’s Hospital of Nanjing Medical University, Huaian, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Jinhuan Xu, Reproductive Center, Huai’an First People’s Hospital of Nanjing Medical University, No. 1, Huanghe Road, Huaiyin District, Huai’an, Jiangsu, People’s Republic of China, Email xjhuan01@163.com

Background: Triptorelin acetate, leuprorelin and goserelin acetate were three commonly used gonadotropin-releasing hormone agonist (GnRH-a) formulations in IVF/ICSI-ET. However, current knowledge about the real-world effects on clinical outcomes of different GnRH-a formulations is limited. In this study, we aimed to compare the clinical outcomes of IVF/ICSI-ET using different GnRH-a formulations in long protocol during follicle phase.
Methods: This is a retrospective study. A total of 154 infertile women undergoing IVF/ICSI-ET in long protocol during follicle phase from September 2019 to December 2023 were assigned to three groups according to different GnRH-a formulations (A: triptorelin acetate; B: leuprorelin; C: goserelin acetate). The baseline information, ovulation induction outcomes and pregnancy outcomes were compared among three groups. Student’s t-test, Pearson Chi-Square test or Fisher’s exact test was used for statistical analysis appropriately.
Results: Groups A, B and C included 94, 36 and 24 patients, respectively. Compared with groups A and B, group C had significantly smaller total amount of gonadotropin (A vs B vs C: 2224.20± 700.02 U vs 2266.67± 884.01 U vs 1685.94± 360.24 U) and shouter days of using gonadotropin (A vs B vs C: 11.61± 1.91 days vs 11.83± 2.48 days vs 9.50± 0.98 days) (P< 0.05). Among the three groups, group C had the best pregnancy outcomes with the highest implantation rate (A vs B vs C: 40.4% vs 32.7% vs 41.9%), clinical pregnancy rate (A vs B vs C: 41.7% vs 39.4% vs 57.9%), live birth rate (A vs B vs C: 32.5% vs 33.3% vs 52.6%) and the lowest miscarriage rate (A vs B vs C: 22.9% vs 15.4% vs 9.1%).
Conclusion: Goserelin acetate was found to have good pregnancy outcomes in IVF/ICSI-ET with small amount and shout using days of gonadotropin, but there is a lack of statistical significance when compared to the pregnancy outcomes of triptorelin acetate and leuprorelin. The findings need future confirmation in larger trials or meta-analyses.

Keywords: gonadotropin-releasing hormone agonists, IVF/ICSI-ET, triptorelin, leuprelin, goserelin