Repeated superovulation induction after failure in previous IVF-ET cycles with the ultra-long protocol: Analysis of outcomes of clinical pregnancy.
- Author:
Bin WANG
1
;
Na KONG
1
;
Jing-Yu LIU
1
;
Ning-Yuan ZHANG
1
;
Ying-Chun ZHU
1
;
Jian-Jun ZHOU
1
Author Information
1. Center of Reproductive Medicine, Drum Tower Hospital Affiliated to Nanjing University School of Medicine, Nanjing, Jiangsu 210008, China.
- Publication Type:Journal Article
- Keywords:
pregnancy outcome;
repeated superovulation;
ultra-long protocol;
IVF-ET
- MeSH:
Endometriosis;
blood;
Estradiol;
blood;
Female;
Fertilization in Vitro;
Follicle Stimulating Hormone;
blood;
Follicle Stimulating Hormone, Human;
blood;
Gonadotropin-Releasing Hormone;
blood;
Humans;
Luteinizing Hormone;
blood;
Oocytes;
Ovarian Follicle;
Ovary;
Ovulation Induction;
methods;
Pregnancy;
Pregnancy Outcome;
Pregnancy Rate;
Recombinant Proteins;
blood;
Retrospective Studies;
Superovulation
- From:
National Journal of Andrology
2017;23(12):1099-1102
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical outcomes of repeated superovulation induction in patients with adenomyosis or moderate to severe pelvic endometriosis after failure in previous IVF-ET cycles with the ultra-long protocol.
METHODS:We retrospectively analyzed the clinical data about 37 patients with adenomyosis or moderate to severe pelvic endometriosis in our center from 2009 to 2013, who underwent repeated IVF-ET after failure in the previous cycles with the ultra-long protocol, namely by injection of 2－6 ampoules of 3.75 mg gonadotropin-releasing hormone agonist (GnRH-a). All the patients met the following requirements: hCG-negative at 14 days after transfer, within 3－7 days after menstruation, and properly down-regulated serum follicle stimulating hormone (FSH) (<10 mIU/ml), luteinizing hormone (LH) (<10 mIU/ml), estradiol (E2) (<30 pg/ml), follicle diameter (<10 mm) and endometrial thickness, and received GnRH (Gonal-F, Serono) for ovulation induction. We compared the clinical and laboratory data and pregnancy outcomes between the first and repeated cycles before and after ovulation induction.
RESULTS:The repeated cycles, as compared with previous ones, showed significant increases in the antral follicle count (AFC) on the first day of stimulation (7.55 ± 1.86 vs 6.45 ± 2.5, P<0.05), number of follicles =≥14 mm in diameter on the hCG trigger day (7.81 ± 3.6 vs 5.56 ± 3.68, P<0.05), level of E2 (［2 362.15 ± 1 210.49］ vs ［1 749.22 ± 1 139.44］ pg/ml, P<0.05), and numbers of oocytes retrieved (7.51 ± 3.23 vs 4.78 ± 3.41, P<0.05) and embryos transferred (2.00 ± 0.33 vs 1.50 ± 0.67, P<0.05), exhibited a remarkably reduction in the dose of GnRH (［1 791.65 ± 1 889.41］ vs ［3 439.56 ± 1 836.53］ IU, P<0.05), and achieved a clinical pregnancy rate of 62.16%.
CONCLUSIONS:With proper reduction of the FSH, LH and E2 levels and follicle diameter, repeated superovulation induction for IVF-ET can improve the ovarian response and pregnancy outcomes of the patients with adenomyosis or moderate to severe pelvic endometriosis after failure in the previous IVF-ET cycles with the ultra-long protocol.
