{"title":"Oral GnRH antagonists for ovulation suppression during ovarian stimulation protocols: systemic review and meta-analysis.","authors":"Nadav Cohen, Ariel Zilbelicht, Chen Nahshon, Suha Seh, Ofer Lavie, Galia Oron","doi":"10.1007/s10815-025-03496-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>The impact of oral GnRH antagonists on IVF treatment outcomes remains unclear. The aim of the study is to investigate the impact of GnRH antagonist over the outcomes of IVF.</p><p><strong>Methods: </strong>We performed an electronic search using MEDLINE® with the OvidSP interface PUBMED, Embase, Web of Science, and Cochrane Library up to December 16, 2024. We included experimental and non-experimental studies, assessing the role of oral GnRH during controlled ovarian stimulation protocols. Our main outcomes were cycle cancelation rate and mean number of mature oocytes retrieved at oocyte pickup (OPU) day.</p><p><strong>Results: </strong>We included four studies comprising 813 patients, of whom 452 women received oral GnRH antagonists and 294 received injectable subcutaneous GnRH antagonists. No statistical differences were noted in the meta-analysis between each outcome measured (cycle cancelation, mean overall and mature oocytes, fertilization rate, and blastulation rate). Using the GRADE criteria, the overall quality of the existing evidence was determined as moderate.</p><p><strong>Conclusions: </strong>This is the first systemic review and meta-analysis to examine the usage of oral GnRH antagonists for ovulation suppression during IVF treatments. Our findings suggest the use of oral GnRH antagonists may be beneficial in infertility treatments; however, caution should be taken, as robust establishment of their effectivity and safety in clinical practice is still pending.</p><p><strong>Trial registration: </strong>Registration Number: PROSPERO study ID: CRD42024599730.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":"1773-1779"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Assisted Reproduction and Genetics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10815-025-03496-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: The impact of oral GnRH antagonists on IVF treatment outcomes remains unclear. The aim of the study is to investigate the impact of GnRH antagonist over the outcomes of IVF.
Methods: We performed an electronic search using MEDLINE® with the OvidSP interface PUBMED, Embase, Web of Science, and Cochrane Library up to December 16, 2024. We included experimental and non-experimental studies, assessing the role of oral GnRH during controlled ovarian stimulation protocols. Our main outcomes were cycle cancelation rate and mean number of mature oocytes retrieved at oocyte pickup (OPU) day.
Results: We included four studies comprising 813 patients, of whom 452 women received oral GnRH antagonists and 294 received injectable subcutaneous GnRH antagonists. No statistical differences were noted in the meta-analysis between each outcome measured (cycle cancelation, mean overall and mature oocytes, fertilization rate, and blastulation rate). Using the GRADE criteria, the overall quality of the existing evidence was determined as moderate.
Conclusions: This is the first systemic review and meta-analysis to examine the usage of oral GnRH antagonists for ovulation suppression during IVF treatments. Our findings suggest the use of oral GnRH antagonists may be beneficial in infertility treatments; however, caution should be taken, as robust establishment of their effectivity and safety in clinical practice is still pending.
Trial registration: Registration Number: PROSPERO study ID: CRD42024599730.
目的：口服GnRH拮抗剂对体外受精治疗结果的影响尚不清楚。本研究的目的是探讨GnRH拮抗剂对体外受精结果的影响。方法：我们使用MEDLINE®与OvidSP接口PUBMED， Embase， Web of Science和Cochrane Library进行电子检索，截止到2024年12月16日。我们纳入了实验和非实验研究，评估口服GnRH在控制卵巢刺激方案中的作用。我们的主要结果是周期取消率和在卵母细胞取卵（OPU）日取出的成熟卵母细胞的平均数量。结果：我们纳入了4项研究，包括813名患者，其中452名女性接受口服GnRH拮抗剂治疗，294名接受皮下注射GnRH拮抗剂治疗。在meta分析中，每个测量结果（周期取消、平均总卵母细胞和成熟卵母细胞、受精率和囊胚率）之间没有统计学差异。使用GRADE标准，现有证据的总体质量被确定为中等。结论：这是第一个系统回顾和荟萃分析，以检查在IVF治疗期间口服GnRH拮抗剂用于抑制排卵的使用。我们的研究结果表明，口服GnRH拮抗剂可能对不孕症治疗有益；然而，应该谨慎对待，因为在临床实践中建立其有效性和安全性仍然悬而未决。试验注册：注册号：PROSPERO研究ID: CRD42024599730。
期刊介绍：
The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species.
The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.
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