A study compared three GnRH‑agonist drugs (triptorelin, leuprorelin, goserelin) used in IVF cycles and found that goserelin required less total hormone and fewer days of dosing, and showed slightly higher pregnancy and live‑birth rates, though the differences weren’t statistically proven.

Triptorelin acetate, leuprorelin and goserelin acetate were three commonly used gonadotropin-releasing hormone agonist (GnRH-a) formulations in IVF/ICSI-ET. However, current knowledge about the real-world effects on clinical outcomes of different GnRH-a formulations is limited. In this study, we aimed to compare the clinical outcomes of IVF/ICSI-ET using different GnRH-a formulations in long protocol during follicle phase. This is a retrospective study. A total of 154 infertile women undergoing IVF/ICSI-ET in long protocol during follicle phase from September 2019 to December 2023 were assigned to three groups according to different GnRH-a formulations (A: triptorelin acetate; B: leuprorelin; C: goserelin acetate). The baseline information, ovulation induction outcomes and pregnancy outcomes were compared among three groups. Student's <i>t</i>-test, Pearson Chi-Square test or Fisher's exact test was used for statistical analysis appropriately. Groups A, B and C included 94, 36 and 24 patients, respectively. Compared with groups A and B, group C had significantly smaller total amount of gonadotropin (A vs B vs C: 2224.20&#xb1;700.02 U vs 2266.67&#xb1;884.01 U vs 1685.94&#xb1;360.24 U) and shouter days of using gonadotropin (A vs B vs C: 11.61&#xb1;1.91 days vs 11.83&#xb1;2.48 days vs 9.50&#xb1;0.98 days) (<i>P</i>&lt;0.05). Among the three groups, group C had the best pregnancy outcomes with the highest implantation rate (A vs B vs C: 40.4% vs 32.7% vs 41.9%), clinical pregnancy rate (A vs B vs C: 41.7% vs 39.4% vs 57.9%), live birth rate (A vs B vs C: 32.5% vs 33.3% vs 52.6%) and the lowest miscarriage rate (A vs B vs C: 22.9% vs 15.4% vs 9.1%). Goserelin acetate was found to have good pregnancy outcomes in IVF/ICSI-ET with small amount and shout using days of gonadotropin, but there is a lack of statistical significance when compared to the pregnancy outcomes of triptorelin acetate and leuprorelin. The findings need future confirmation in larger trials or meta-analyses.