Effects of Different Ovulatory Drugs on Clinical Outcomes in the Long GnRH agonist Protocol with Suboptimal Ovarian Response
- VernacularTitle:GnRH激动剂长方案中不同促排卵药物对卵巢慢反应分娩结局的影响
- Author:
Xiao-shi1 TANG
1
;
Can-xin2 WEN
2
;
Ping2 PAN
2
;
Yu2 LI
2
Author Information
1. Beijing Aerospace General Hospital，Beijing 100076，China； IVF center，Sun Yat-sen Memorial Hospital，Sun Yat-sen University，Guangzhou 510120，China
2. IVF center，Sun Yat-sen Memorial Hospital，Sun Yat-sen University，Guangzhou 510120，China
- Publication Type:Journal Article
- Keywords:
gonadotropin releasing hormone agonist, pituitary down- regulation, suboptimal response, luteinizing hormone
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(1):127-134
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】To investigate the effect of adding different preparations containing luteinizing hormone activity in patients with normal ovarian reserve but suboptimal response during GnRH agonist protocol when undergoing IVF/ICSI- ET.【Methods】872 infertile patients with normal ovarian reserve but suboptimal response to FSH during GnRH agonist protocol were enrolled. According to the supplementation of different preparations containing LH activity ，patients were divided into three groups，including low- dose hCG group（n=28），rLH group（n=319）and HMG group（n=525）. The clinical parameters and pregnancy outcomes were retrospectively compared among three groups.【Results】The proportion of ultra-long GnRH-a protocol in hCG group was higher than that in HMG group（14.3% vs. 1.1%，P＜0.001）. The total duration and dosage gonadotrophin in hCG group were more than that in HMG group ［15.0（13.0~16.8）vs. 13.0（12.0~15.0）days ，P = 0.027 ；2 925（2 531~3 900）vs. 2 550（2 100~3 225）U ，P = 0.046］. The total duration and dosage gonadotrophin in rLH group were less than that in HMG group［13.0（12.0~14.0）vs. 13.0（12.0~15.0）days，P = 0.009；2 400（1 950~3 075）vs. 2 550（2 100~3 225）U ，P = 0.009］. There were 53.6%（15/28）patients who still showed suboptimal response after the administration of HMG or rLH in hCG group. The clinical pregnancy rate（69.2%，58.6% vs.63.8%；P＞0.05）and live birth rate（65.4%，49.6% vs. 53.1%；P＞0.05）were similar among these groups.【Conclusions】 For patients with normal ovarian reserve but suboptimal response during GnRH agonist protocol ，the supplementation of different preparations containing LH activity showed comparable effect on pregnancy outcomes. The addition of low- dose hCG was effective even when patients still showed suboptimal response after the administration of HMG or rLH.
