A comparative study on the effects of intermittent drug withdrawal and small follicle aspiration on clinical outcomes in COH high-responders
- Author:
Jun YANG
1
Author Information
- Publication Type:Journal Article
- Keywords: COH; IVF-ET; intermittent withdrawal protocol; small follicular aspiration
- From: Chinese Journal of Practical Gynecology and Obstetrics 2019;35(07):815-819
- CountryChina
- Language:Chinese
- Abstract: OBJECTIVE: To explore the treatment strategy for patients with hyperresponsiveness in the early and middle stages of superovulation induction(COH)by GnRH agonist down-regulation protocol in in vitro fertilization-embryo transfer(IVF-ET).METHODS: An analysis was made in 127 cases of IVF-ET performed in Reproductive Center of Shantou Central Hospital from June 2017 to June 2018.The patients were divided into 3 groups according to the different treatment:intermittent drug withdrawal group(group A),small follicle aspiration group(group B),and control group(group C).The embryo quality,pregnancy outcome,incidence of ovarian hyperstimulation syndrome(OHSS)and the number of cancelled fresh transplantation cycles were compared among the three groups.The embryo quality and pregnancy outcome was further compared between discontinuous withdrawal once(A1 group)and 2-3 times(A2 group),and between 1 day(A3 group)and 2-3 days(A4 group).RESULTS: The E2 level on HCG day,the rate of moderate and severe OHSS,cancellation rate and miscarriage rate in group A and group B were significantly lower than those in group C(P<0.05),but high-quality embryos rate was significantly higher than group C(P<0.05).There was no significant difference in clinical pregnancy rate among the three groups(P>0.05).There was no significant difference in embryo quality or clinical outcomes between group A1 and A2,and between group A3 and A4(P>0.05).CONCLUSION: The intermittent withdrawal regimen is non-invasive,safe and simple,and can improve the quality of embryos.It is a suitable regimen for high-response patients to improve the chance of fresh transplantation.