Study of GnRH Agonist Spray Versus Vaginal Progesterone for Luteal Support in Women Undergoing IVF Evaluating How GnRH Agonist Works to Support Pregnancy After Fresh Embryo Transfer

What this Trial Is About

Researchers are investigating the use of GnRH agonists as the sole luteal phase support during IVF treatment for women undergoing a GnRH antagonist protocol with fresh embryo transfer. The study aims to understand how GnRH agonists work to improve pregnancy outcomes and to identify factors that may predict treatment success or failure. This observational study involves women aged 18 to 45 undergoing their first to third IVF cycle for various infertility causes. Participants will follow a controlled ovarian stimulation protocol with gonadotropins and daily GnRH antagonist injections until ovulation induction. Ovulation triggering is done with hCG, GnRH agonist, or a combination depending on the risk of ovarian hyperstimulation syndrome. After egg retrieval and fertilization via IVF or ICSI, embryos are cultured and transferred. Luteal phase support is provided either by intranasal GnRH agonist spray 200 mcg Nafarelin twice daily for two weeks or vaginal progesterone, with progesterone continuing in pregnancy up to 8-10 weeks. Throughout the study, blood and follicular fluid samples will be collected at six time points to measure hormonal, inflammatory, and angiogenic markers. Researchers will monitor demographic and clinical data, IVF cycle parameters, embryo quality, and pregnancy outcomes such as positive pregnancy rate, miscarriage, live birth, and complications like OHSS. The study lasts at least two weeks after embryo transfer for primary outcomes, with further follow-up for pregnancy progress.

GnRH for Luteal Support - Mechanism of Action