Comparison of the clinical outcomes of three ovulation induction protocols in elderly patients with decline in ovarian reserve
10.3760/cma.j.cn101441-20190325-00121
- VernacularTitle:高龄合并卵巢储备功能低下患者三种促排卵方案的临床结局比较
- Author:
Juan ZHENG
1
;
Liming ZHOU
1
;
Yiting SUN
1
;
Aili XIA
1
;
Mai LI
1
;
Kun LIANG
1
Author Information
1. 宁波市妇女儿童医院生殖中心 315000
- Publication Type:Journal Article
- Keywords:
Ovarian reserve dysfunction;
Gonadotropin-releasing hormone antagonist protocol;
Progestin-primed ovarian stimulation;
Cost-effectiveness ratio
- From:
Chinese Journal of Reproduction and Contraception
2020;40(3):194-200
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical outcomes and cost-effectiveness ratio of the patients with ovarian reserve dysfunction in three different ovulation induction protocols during in vitro fertilization-embryo transfer (IVF-ET), and to explore a cost-effective ovulation induction protocol. Methods:A retrospective analysis was made on the low prognosis in IVF-ET of elderly patients with low ovarian reserve function (according to POSEIDON criteria, group 4) in Reproductive Center of Ningbo Women & Children Hospital during January 2017 to October 2018. According to the different ovarian stimulation protocols used, they were divided into three groups: antagonist group (group A, 169 cycles), micro-stimulation group (group B, 57 cycles), and progestin-primed ovarian stimulation (PPOS) group (group C, 59 cycles). The clinical outcome and cost-effectiveness of three ovulation-promoting protocols were analyzed.Results:In group A, compared with group B and group C, both the number of obtained eggs [4.46±1.45, 2.42±1.12, 3.28±1.62, respectively in the three groups ( P=0.013, P=0.021)] and the cumulative clinical pregnancy rate were higher (35.50%, 21.43%, 23.73%, respectively in the three groups)( P=0.012, 0.021). In group A, the rate of cycle cancellation was the lowest in the three groups (0.95%, 21.05%, 15.24%, respectively). In group A, the average cost of each egg acquisition was the lowest [(3817±1450) yuan, (5868±1820) yuan, (4484±1678) yuan, respectively in the three groups)]( P=0.001, P=0.012, P=0.017), and the cost of each available embryo was the lowest too [(7276±2329) yuan, (7978±2560) yuan, (7466±2175) yuan, respectively in the three groups)]( P=0.001, P=0.021, P=0.033).The cost per clinical pregnancy was lower in group A than in group B and group C [(47 957±22 388) yuan, (67 450±35 210) yuan, (61 984±33 463) yuan, respectively in the three groups)]( P=0.012, P=0.021). Conclusion:For patients aged over 35 years with poor ovarian reserve before stimulation, antagonist protocol was superior to micro-stimulation and PPOS, considering the clinical outcome and cost-effectiveness ratio, and it was an ideal ovary stimulation protocol.
