摘要
Abstract
Objectives:To explore the outcomes of in vitro fertilization(IVF)with femoston pretreatment for natural cycle protocol in patients with premature ovarian insufficiency.
Methods:A total of 174 cycles from patients with primary ovarian insufficiency(POI)who underwent IVF-embryo transfer(ET)treatment at Reproductive Medical Center of Tongji Hospital of Tongji University from January 2022 to June 2024 were retrospectively reviewed.According to the protocols of ovulation induction,they were divided into four groups as gonadotropin-releasing hormone(GnRH)antagonist protocol group(n=43),progestin primed ovarian stimulation(PPOS)protocol group(n=44),minimal stimulation protocol group(n=42)and nature cycle protocol with femoston pretreatment group(n=45).The ovulation induction outcomes and clinical outcomes of the four groups were compared.
Results:As for the general clinical data,there were no significant differences in age,body mass index(BMI),levels of basal sex hormones,anti-Müllerian hormone(AMH)level,and antral follicle count(AFC)among the four groups of patients(P＞0.05).Regarding the ovulation induction outcomes,the duration of gonadotropin(Gn)administration,number of retrieved oocytes,and MⅡ oocyte rate in the nature cycle protocol with femoston pretreatment group were significantly lower than those in the other three groups(P＜0.05),the estradiol(E2)level on the human chorionic gonadotropin(HCG)day in minimal stimulation protocol group was significantly lower than those in the other three groups(P＜0.05),the luteinizing hormone(LH)level on the HCG day in GnRH antagonist protocol group was significantly lower than those in the other three groups(P＜0.05),and there were no significant differences in the 2PN rate and high-quality embryo rate among the four groups(P＜0.05).For embryo transfer outcomes,both GnRH antagonist protocol group and nature cycle protocol with femoston pretreatment group used fresh embryo transfer and freeze-thaw embryo transfer,while the other two groups only used freeze-thaw embryo transfer.The proportion of patients undergoing cleavage-stage embryo transfer in nature cycle protocol with femoston pretreatment group was significantly higher than those in the other three groups(P＜0.05),the endometrial thickness on the transfer day in minimal stimulation protocol group was significantly thinner than those in the other three groups(P＜0.05),the proportion of cycles with single-embryo transfer in nature cycle protocol with femoston pretreatment group was significantly higher than those in the other three groups(P＜0.05).With regard to pregnancy outcomes,there were no statistically significant differences in the cancellation rate of transplantation cycles,biochemical pregnancy rate,clinical pregnancy rate and twin pregnancy rate among patients receiving the four different ovulation induction protocols(P＞0.05).
Conclusions:Compared with GnRH antagonist protocol,PPOS protocol,and minimal stimulation protocol,the natural cycle protocol pretreated with femoston results in similar pregnancy outcomes,so it can be used as an option for POI patients when they seek for assisted reproductive technology treatment.关键词
早发性卵巢功能不全/拮抗剂方案/高孕激素状态下促排卵方案/芬吗通预处理/自然周期方案/妊娠结局Key words
Premature ovarian insufficiency/Gonadotropin-releasing hormone antagonist protocol/Progestin primed ovarian stimulation protocol/Femoston pretreatment/Nature cycle protocol/Pregnancy outcome分类
医药卫生
