Abstract
Objectives:To investigate whether endometriosis(EMs)affects the outcomes of ovarian stimulation using a gonadotropin releasing hormone(GnRH)antagonist protocol,and to evaluate the effect of luteinizing hormone(LH)supplementation on the outcomes of ovarian stimulation with GnRH antagonist protocol in patients with EMs.
Methods:A retrospective analysis was conducted on the clinical data of patients who underwent in vitro fertilization/intra-cytoplasmic sperm injection(IVF/ICSI)assisted reproduction using a GnRH antagonist protocol at Nanjing Drum Tower Hospital from January 2021 to June 2024.According to infertility factors,patients were divided into an EMs group and a non-EMs group.Propensity score matching(PSM)was performed at a 1∶1 ratio,with 421 cycles included in each group.Baseline characteristics and ovarian stimulation outcomes were compared between the two groups.Furthermore,within each group,patients were subdivided into an LH supplementation subgroup and a non-LH supplementation subgroup based on whether LH was added during ovarian stimulation.PSM was again applied at a 1∶1 ratio.Ultimately,145 cycles were included in both the LH supplementation and non-supplementation subgroups within the EMs group,respectively.While 851 cycles were included in each corresponding subgroup within the non-EMs group.Baseline characteristics and ovarian stimulation outcomes were compared among the subgroups.
Results:After PSM,there were no significant differences in baseline characteristics between the EMs and non-EMs groups,including age,body mass index(BMI),baseline sex hormone levels,anti-Müllerian hormone(AMH)level,antral follicle count(AFC),and the proportion of IVF/ICSI cycles(P＞0.05).Additionally,there were no significant differences between the two groups in total dosage and duration of gonadotropin used,number of oocytes retrieved,oocyte maturation rate(MⅡ rate),fertilization rate,normal fertilization rate,available embryo rate and blastocyst formation rate(P＞0.05).In the EMs group,there were no significant differences in baseline characteristics in terms of age,BMI,baseline sex hormone levels,AMH level,AFC and the proportion of IVF/ICSI cycles between the LH supplementation and non-supplementation subgroups(P＞0.05).The number of oocytes retrieved,MⅡ rate,fertilization rate,and normal fertilization rate were also comparable between the two subgroups(P＞0.05).However,the available embryo rate(57.34％vs.51.90％)and blastocyst formation rate(75.44％vs.68.56％)were significantly higher in the LH supplementation subgroup than those in the non-supplementation subgroup(P＜0.05).In the non-EMs group,there were no significant differences in baseline characteristics,number of oocytes retrieved,MⅡ rate,fertilization rate,available embryo rate and blastocyst formation rate between the LH supplementation and non-supplementation subgroups(P＞0.05).Additionally,after PSM,no significant difference was observed in cumulative pregnancy rate between the EMs and non-EMs groups(P＞0.05),nor between the LH supplementation and non-supplementation subgroups within the EMs group(P＞0.05).
Conclusions:EMs does not reduce oocyte maturation rate,normal fertilization rate,available embryo rate and blastocyst formation rate in ovarian stimulation cycles of GnRH antagonist protocol.In patients with EMs,LH supplementation during ovarian stimulation with an GnRH antagonist protocol can significantly improve available embryo rate and blastocyst formation rate,suggesting that LH supplementation may enhance oocyte quality in EMs patients undergoing GnRH antagonist protocol.关键词
子宫内膜异位症/卵母细胞质量/黄体生成素/拮抗剂方案Key words
Endometriosis/Oocyte quality/Luteinizing hormone/GnRH antagonist protocol分类
临床医学
