张欣 1张玉 1王雪莹 1刘帅 1郭薇 1姚冠峰 1张会霞 1刘效群1
作者信息
- 1. 河北省计划生育科学技术研究院,河北省生殖医学中心,国家卫计委计划生育与优生重点实验室,石家庄 050071
- 折叠
摘要
Abstract
Objective:To compare the clinical outcome between progestin-primed ovarian stimulation (PPOS) protocol and GnRH-agonist (GnRH-a) long protocol in different age group in IVF with donor semen (D-IVF) cycle.Methods:A retrospective analysis was performed in a total of 385 D-IVF cycles in our reproductive center from January 2015 to November 2016,and all of the sperms were from the sperm bank.The patients were divided into two groups according to the age:<35 years group and ≥35 years group,and the patients were subdivided into PPOS protocol group and GnRH-a long down-regulation protocol group (GnRH-a group).The total amount of gonadotropin (Gn),duration of used Gn,the number of oocytes retrieved,laboratory indexes,the clinical outcome of frozen embryo transfer (FET) and complications were compared among the groups.Results:(1) There were no significant differences between the two protocols in age,infertility years,BMI,basal levels of FSH,LH,E2 and number of follicular follicles (AFC)(P>0.05).(2) In the group less than 35 years group,the total amount of Gn,the days of Gn used and the number of oocytes retrieved in PPOS group were significantly lower than those in GnRH-a group (P<0.05).There were no significant differences in the 2PN rate,cleavage rate of 2PN embryos,transplantable embryo rate,good-quality embryo rate,embryo utilization rate and incidence of ovarian hyper stimulation syndrome(OHSS) (P>0.05).(3) In the≥35 years group,the total amount of Gn,days of Gn used,number of oocytes retrieved and 1PN fertilization rate in PPOS group were significantly lower than those of GnRH-a group.However,the of 2PN rate (80.00% vs.67.54%),transplantable embryo rate (50.00% vs.36.23%),good-quality embryos rate (40.74% vs.25.66%),and embryo utilization rate (79.63% vs.65.92%) in PPOS group were significantly higher than those of GnRH-a group (all P<0.05),while no differences were found in clinical pregnancy rate of FET between the two protocols (52.78% vs.47.73%,P>0.05).Conclusions:PPOS protocol significantly increases the fertility rate and good-quality embryo rate in elderly patients.It is more suitable for elderly patients for ovulation induction compared with the GnRH-a long protocol.关键词
高孕激素状态下促排卵/长方案/年龄/供精体外受精-胚胎移植Key words
Progestin-primed ovarian stimulation/GnRH-a long protocol/Age/IVF with donor sperm
