生殖医学杂志2025，Vol.34Issue(10)：1307-1313,7.DOI:10.3969/j.issn.1004-3845.2025.10.002
激动剂方案和拮抗剂方案应用于波塞冬标准组2人群的临床结局比较
Clinical outcomes of GnRH agonist protocol versus GnRH antagonist protocol in POSEIDON group 2 patients
摘要
Abstract
Objectives:To compare the clinical outcomes of three distinct ovarian stimulation protocols,namely the long-acting gonadotropin-releasing hormone(GnRH)agonist protocol,the short-acting GnRH agonist protocol,and the GnRH antagonist protocol in POSEIDON group 2 patients. Methods:A retrospective cohort study design was employed to analyze the clinical data from patients who underwent IVF/ICSI-ET treatment at the Center for Reproductive Medicine of Remin Hospital of Wuhan University from January 2020 to June 2023.The study population consisted of low-prognosis patients meeting the diagnostic criteria for POSEIDON group 2.Based on the ovarian stimulation protocols administered,the patients were categorized into three groups:the long-acting GnRH agonist protocol group(n=92),the short-acting GnRH agonist protocol group(n=106)and the GnRH antagonist protocol group(n=118).The basic characteristics,controlled ovarian stimulation,embryonic development and pregnancy outcomes of fresh embryo transfer cycles were compared among the three groups. Results:As for the baseline characteristics,no significant differences were found in age,ovarian reserve function,infertility years and infertility types among the three groups(P＞0.05).The GnRH antagonist protocol group demonstrated a significant reduction in total gonadotropin(Gn)consumption when compared to other groups(P＜0.05).The Gn stimulation duration revealed significant intergroup variations,with the longest duration in long-acting GnRH agonist protocol group,and the shortest duration in GnRH antagonist protocol group(P＜0.05).The serum estradiol(E2)levels measured on trigger day were markedly elevated in the the short-acting GnRH agonist protocol group compared with those in the other groups(P＜0.05).The differences in serum luteinizing hormone(LH)levels on trigger day among three groups were significant,with the lowest levels observed in the long-acting GnRH agonist protocol group and the highest ones in the GnRH antagonist protocol group(P＜0.05).In the IVF cycles,the short-acting GnRH agonist protocol group demonstrated a remarkably higher number of retrieved oocytes compared to the GnRH antagonist protocol group(P＜0.05).The rate of fresh embryo transfer in GnRH antagonist protocol group was significantly lower than that in the other two groups(P＜0.05),and the embryo implantation rate and live birth rate were remarkably lower in the GnRH antagonist protocol group than those in the long-acting GnRH agonist protocol group(P＜0.05). Conclusions:For POSEIDON group 2 patients,the long-acting GnRH agonist protocol may be preferable for those opting for fresh embryo transfer,while the GnRH antagonist protocol could reduce Gn dosage when a freeze-all strategy is adopted.In clinical practice,we can choose the most appropriate ovarian stimulation protocol according to the transfer strategy of patients.关键词
拮抗剂方案/激动剂方案/低预后/妊娠结局Key words
GnRH antagonist protocol/GnRH agonist protocol/Low prognosis/Pregnancy outcome分类
医药卫生引用本文复制引用
景雪,漆倩荣,谢青贞..激动剂方案和拮抗剂方案应用于波塞冬标准组2人群的临床结局比较[J].生殖医学杂志,2025,34(10):1307-1313,7.基金项目
国家自然科学基金(82471669) （82471669）
湖北省重点研发计划项目(2021BCA107) （2021BCA107）
武汉大学人民医院交叉创新人才项目(JCRCFZ-2022-026) （JCRCFZ-2022-026）
