Effect of the proportion of follicles with a diameter ≥14 mm on human chorionic gonadotropin injection day and follicular output rate on the pregnancy rate of fresh embryo transfer in patients with polycystic ovary syndrome
10.3760/cma.j.cn101441-20191113-00507
- VernacularTitle:人绒毛膜促性腺激素注射日直径≥14 mm卵泡数比例和卵泡输出率对多囊卵巢综合征患者新鲜胚胎移植妊娠率的影响
- Author:
Lijun ZHANG
1
;
Yayi GAO
1
;
Mengmeng TIAN
1
;
Xingling WANG
1
Author Information
1. 郑州大学第三附属医院生殖医学中心 450052
- Publication Type:Journal Article
- Keywords:
Follicle diameter;
Follicular output rate;
Polycystic ovary syndrome
- From:
Chinese Journal of Reproduction and Contraception
2020;40(12):986-993
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of the proportion of follicle diameter ≥14 mm on human chorionic hormone (hCG) injection day and follicular output rate (FORT) on the pregnancy outcome of fresh embryo transfer in patients with polycystic ovary syndrome (PCOS) by using long-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol in follicular phase.Methods:The data of 811 fresh embryo transfer cycles of PCOS patients assisted by long-acting GnRH-a long protocol in follicular phase were analyzed retospectively from May 2017 to May 2018 in the Center for Reproductive Medicine of the Third Affiliated Hospital of Zhengzhou University. According to the proportion of follicles with a diameter ≥14 mm on hCG injection day, patients were divided into three groups: group A (proportion≤60%), group B (proportion 60%-80%) and group C (proportion≥80%). According to the FORT, patients were divided into three groups: group D (proportion≤40%), group E (proportion 40%-60%) and group F (proportion≥60%). The clinical and laboratory indicators of patients in each group were compared and analyzed. According to the pregnancy outcomes, patients were divided into pregnancy group and non-pregnancy group. The clinical data of the two groups were compared, and the influencing factors of clinical pregnancy outcomes were analyzed by binary logistic regression.Results:The number of retrieved oocytes of groups A, B and C increased in turn ( P<0.001). The fertility rate of two pronuclei (2PN) in group A (59.78%) was lower than that in group B (62.40%, P=0.013). There was no significant difference among the three groups in embryo implantation rate, clinical pregnancy rate and live birth rate ( P>0.05). The number of retrieved oocytes in groups D, E and F increased ( P<0.001), but the 2PN rate in group F (59.13%) was significantly lower than that in group D (62.98%, P=0.009) and group E (64.05%, P<0.001). Embryo implantation rate, clinical pregnancy rate and live birth rate in group F were lower than those in group E (51.76% vs. 61.56%, P=0.002; 62.72% vs. 72.70%, P=0.007; 52.33% vs. 61.84%, P=0.011), while those in group D (56.77%, 69.94%, 59.54%) were not significantly different from those in the other two groups ( P>0.05). Compared with pregnancy group, the proportion of dominant follicles on hCG injection day in non-pregnancy group was not significantly different ( P>0.05), while FORT in pregnancy group was lower than that in non-pregnancy group ( P=0.031). Logistic regression analysis showed that FORT was an independent influencing factor for clinical pregnancy [ OR=0.995, 95% CI=0.974-1.016, P=0.039]. Conclusion:In PCOS patients, the proportion of follicles with a diameter ≥14 mm on hCG injection day does not affect pregnancy outcomes, the FORT is of great significance in predicting pregnancy outcomes, and the middle and low proportion of FORT group can obtain better pregnancy outcomes.
