Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2023, Vol. 19 ›› Issue (06): 629 -635. doi: 10.3877/cma.j.issn.1673-5250.2023.06.002

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Current research status in effect of gonadotropin-releasing hormone antagonist on endometrial receptivity

Li Wang1, Yueying Wang2, Fen Zhou3, Yukun Guo4, Lina Wei2,()   

  1. 1. School of Clinical Medicine of Jining Medical University, Jining 272000, Shandong Province, China; Key Laboratory of Pregnancy Disorders Research of Jining City, Jining 272000, Shandong Province, China
    2. Key Laboratory of Pregnancy Disorders Research of Jining City, Jining 272000, Shandong Province, China; Department of Reproductive Medicine of Jining No.1 People′s Hospital, Jining 272000, Shandong Province, China
    3. Department of Reproductive Medicine of Jining No.1 People′s Hospital, Jining 272000, Shandong Province, China
    4. School of Clinical Medicine of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
  • Received:2023-06-22 Revised:2023-11-09 Published:2023-12-01
  • Corresponding author: Lina Wei
  • Supported by:
    National Natural Science Foundation for Youth of China(82101756)

Compared with classical gonadotropin-releasing hormone agonist (GnRH-a) used in the field of assisted reproductive technology (ART), newly developed gonadotropin-releasing hormone antagonist (GnRH-A) in recent years has the following advantages of being more in line with physiological processes of women. ①Shorten the ART treatment cycle. ②Reduced the amount of ART exogenous gonadotropin. ③There is no occurrence of hypogyny symptoms due to the down-regulation of GnRH-a. ④Significantly reduce the incidence of ovarian hyperstimulation syndrome (OHSS). ⑤Significantly reduce cycle cancellation rate.Results of literature studies showed that the clinical pregnancy rate of infertile patients with treatment of GnRH-a and GnRH-A was lower if the GnRH-A protocol was adopted in fresh embryo (3 d embryo) transfer cycles than the GnRH-a protocol, and the difference was statistically significant (P<0.05); however, in the case of frozen embryo transfer, there was no statistically significant difference in pregnancy rate between two protocols (P>0.05). This suggested that the lower pregnancy rate of GnRH-A during the fresh embryo transfer cycle may be caused by the adverse effects of GnRH-A on endometrial receptivity of infertile patients, rather than the reason of ovum quality and embryo development. The speculation that GnRH-A may affect endometrial receptivity is inconclusive so far. The author intends to elaborate the latest research progress on endometrium receptivity related protein expression levels, related molecular expression levels, the effects of related immune cell function and quantity on endometrial thickness and blood flow in women undergoing in vitro fertilization and embryo transfer (IVF-ET) with GnRH-A protocol. The aim is to reveal the mechanism of endometrial receptivity deficiency in infertile patients caused by GnRH-A protocol, so as to find new targets for the treatment of endometrial receptivity deficiency, improve the clinical pregnancy success rate of patients taking GnRH-A protocol, and provide theoretical reference for optimizing the treatment of GnRH-A.

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