A modified flexible GnRH antagonist protocol using antagonist early cessation and a gonadotropin step-down approach improves live birth rates in fresh cycles: a randomized controlled trial

What Was Tested

This randomized controlled trial looks at hCG (human chorionic gonadotropin).

Currently, there is no consensus on optimal GnRH antagonist regimens.

Endometrial receptivity is a key factor that contributes to this phenomenon.

Who Took Part

The abstract describes 546 patients taking part.

The age groups tagged for this paper are adults, both men and women.

There were 546 patients allocated to either the modified GnRH antagonist or the conventional antagonist protocol at a 1:1 ratio.

Only women under 40 years of age who had a good prognosis were included in the analysis.

How the Study Was Run

In design terms this was a randomized and open-label study.

Because people in this hCG (human chorionic gonadotropin) study were split into groups at random, differences between the groups are less likely to reflect who happened to join each one.

Being open-label, the hCG (human chorionic gonadotropin) study did not mask who received what.

An open label randomized controlled trial (RCT) was performed between November 2021 and August 2022.

Both IVF and ICSI cycles were included, and the sperm samples used were either fresh or frozen from the partner, or from frozen donor ejaculates.

The primary outcome was the LBRs per fresh SET cycle.

Secondary outcomes included rates of implantation, clinical and ongoing pregnancy, miscarriage, and ovarian hyperstimulation syndrome (OHSS), as well as clinical outcomes of ovarian stimulation.

What Was Measured

The subject headings attached to it are Gonadotropin-Releasing Hormone, Birth Rate, Ovulation Induction, Hormone Antagonists, Pregnancy Rate, Live Birth and Fertilization in Vitro.

Author keywords: GnRH antagonist protocol, IVF, endometrial receptivity, live birth rate, progesterone elevation and single embryo transfer.

What This Means in Plain Language

The paper is a randomized and open-label study of hCG (human chorionic gonadotropin) in 546 patients.

With several hundred people or more, it is a fairly large study for this kind of research.

Results are reported in around 6 sentences of the abstract; we leave them to the paper itself rather than summarise them.

The publication is from 2024 (Human reproduction (Oxford, England)), a journal based in England.

More context: the hCG (human chorionic gonadotropin) compound page, all human trials.