GnRH-agonist pretreatment in hormone replacement therapy improves pregnancy outcomes in women with male-factor infertility.

GnRHa-HRT pretreatment was associated with a significantly higher live birth rate compared to HRT alone in women with male-factor infertility undergoing FET.

• Multivariate logistic regression showed OR 2.154 (95% CI 1.636–2.835, P<0.001) for live birth in the GnRHa-HRT group vs. HRT group
• IPTW method was used to balance baseline characteristics between groups and reduce selection bias
• 2733 women with male-factor infertility were enrolled between January 2016 and October 2020 at two Reproductive Medicine Centres
• Live birth rate was considered the primary pregnancy outcome

The miscarriage rate was significantly lower in the GnRHa-HRT group compared to the HRT group.

• Reduction in miscarriage rate was identified as a statistically significant finding
• This finding was reported alongside the primary outcome of live birth rate
• The analysis was conducted after IPTW adjustment to control for confounding

The GnRHa-HRT group had significantly higher rates of biochemical pregnancy, clinical pregnancy, multiple pregnancy, and term birth compared to the HRT group.

• All four secondary outcomes—biochemical pregnancy, clinical pregnancy, multiple pregnancy, and term birth—were significantly higher in the GnRHa-HRT group
• These outcomes were assessed in 2733 women with male-factor infertility undergoing HRT-based FET protocols
• Confounding factors were adjusted for using multivariate logistic regression and IPTW weighting

The study population consisted exclusively of women with male-factor infertility who underwent HRT as their endometrial preparation method for FET.

• 2733 women were enrolled from two Reproductive Medicine Centres between January 2016 and October 2020
• Patients were divided into GnRHa-HRT group and HRT group based on whether they received GnRH-a pre-treatment
• Male-factor infertility was the sole indication for inclusion, which differs from prior studies that often included mixed infertility diagnoses