# Effects of different ovulation induction protocols on pregnancy outcomes of fresh cycles in patients undergoing in vitro fertilization-embryo transfer with donor sperm

## TL;DR

This study compares different ovulation induction protocols in IVF with donor sperm and finds that the GnRH-a long protocol has the highest pregnancy success rate.

## Contribution

The study provides evidence that the GnRH-a long protocol is most effective for fresh embryo transfers in IVF-D cycles.

## Key findings

- The GnRH-ant protocol required the shortest duration of Gn administration and lowest total Gn dose.
- The GnRH-a long protocol had the highest clinical pregnancy rate.
- Clinical pregnancy and live birth rates significantly differed among the three groups.

## Abstract

This study analyzed clinical pregnancy outcomes in patients undergoing in vitro fertilization-embryo transfer with donor sperm (IVF-D) using different ovulation induction protocols, to provide reference data for selecting appropriate protocols.

Data from 1801 cycles in patients who underwent IVF-D in Peking University Third Hospital between June 2010 and June 2021 were retrospectively analyzed. Participants were divided into three groups based on the controlled ovarian hyperstimulation protocol: follicular-phase ultralong gonadotropin-releasing hormone agonist (GnRH-a), luteal-phase GnRH-a long, and gonadotropin-releasing hormone antagonist (GnRH-ant) protocol groups.

Significant differences were observed among the groups in gonadotropin (Gn) starting dose, Gn administration duration, total Gn dose, estradiol level on the day of human chorionic gonadotropin (hCG) administration (hCG day), progesterone level on hCG day, luteinizing hormone level on hCG day, endometrial thickness on hCG day, and number of embryos transferred (p < 0.05). We also found significant group differences in the number of eggs retrieved, two pronucleizygotes, and cleavages (p < 0.05), but not in high-quality embryos (p < 0.05). Clinical pregnancy and live birth rates significantly differed among the three groups (p < 0.05), whereas ectopic pregnancy, early miscarriage, and multiple pregnancy rates did not (p < 0.05).

In fresh embryo transfer cycles, the GnRH-ant protocol required the shortest duration of Gn administration and lowest total Gn dose, whereas the GnRH-a long protocol had the highest clinical pregnancy rate. Therefore, the GnRH-a long protocol is considered the preferred method for female patients who can undergo fresh transfers during IVF-D cycles.