生殖医学杂志2024，Vol.33Issue(5)：577-584,8.DOI:10.3969/j.issn.1004-3845.2024.05.003
GnRH拮抗剂应用天数对IVF/ICSI-ET临床结局的影响
Effects of the duration of GnRH antagonist application on clinical outcomes of IVF/ICSI-ET
摘要
Abstract
Objective:To investigate whether the duration of GnRH antagonist application affects the clinical outcomes of fresh IVF/ICSI-ET cycles in the flexible GnRH antagonist protocol. Methods:A retrospective analysis of data of infertility patients who underwent IVF/ICSI-ET treatment in Women and Children's Hospital,Qingdao University,from October 2019 to October 2022 was conducted.The respondents were divided into 4 groups based on the duration of antagonist application:group A(≤3 days of antagonist application,151 cycles),group B(4 days of antagonist application,592 cycles),group C(5 days of antagonist application,672 cycles),group D(≥6 days of antagonist application,217 cycles).Basic clinical characteristics,ovulation induction and clinical outcomes of the four groups were compared,and the influencing factors of clinical outcomes were analyzed by the univariate and multivariate logistic regression and multiple linear regression. Results:Among the four groups of patients,except for group A,whose body mass index(BMI)was significantly higher than those of the other three groups(P＜0.05),there were no significant differences in the comparison of basic data among the other groups(P＞0.05).Patients in group D had significantly higher total gonadotropin(Gn)dosage,total Gn days,progesterone and E2 levels on the trigger day,and endometrial thickness than those of the other three groups(P＜0.05),while LH levels on the trigger day were significantly lower than those of the other three groups(P＜0.05).The clinical outcomes of the four groups were as follows.Patients in group A had the highest proportion of embryos transferred during the cleavage stage,group C had the highest proportion of embryos transferred during the blastocyst stage(P＜0.05).Both the normal fertilization rate and the high-quality embryo rate of group D were significantly higher than those of the other three groups(P＜0.05).The blastocyst formation rate in group C was significantly higher than those in the other three groups(P＜0.05).However,there were no significant differences in the implantation rate,clinical pregnancy rate,early miscarriage rate,and the live birth rate among the four groups of patients(P＞0.05).Logistic regression analysis showed that the duration of antagonist application was not a factor for the clinical pregnancy rate(P＞0.05),and the LH level,endometrial thickness and the number of transplanted embryos on HCG day were positively correlated with the clinical pregnancy rate(OR＞1,P＜0.05).Multiple linear regression analysis showed that the duration of antagonist application was negatively correlated with LH level on HCG day(B＜0,P＜0.05),and positively correlated with endometrial thickness(B＞0,P＜0.05). Conclusions:The duration of GnRH antagonist application did not affect the clinical pregnancy rate and the live birth rate of fresh IVF/ICS1-ET cycles,but much more attention should be paid to the relationships between the duration of GnRH antagonist application as well as clinical indicators such as hormone levels,endometrial thickness and the number of oocytes retrieved during ovulation.关键词
拮抗剂灵活方案/临床妊娠/体外受精/卵胞浆内单精子注射-胚胎移植Key words
Antagonist flexible scheme/Clinical pregnancy/IVF/ICSI-ET分类
医药卫生引用本文复制引用
杨婧杰,郝翠芳,徐仰英,李端,王霄霄..GnRH拮抗剂应用天数对IVF/ICSI-ET临床结局的影响[J].生殖医学杂志,2024,33(5):577-584,8.基金项目
国家自然科学基金(82201801) （82201801）
