Investigate the optimal number of oocytes retrieved of early follicular phase prolonged protocol
10.3760/cma.j.cn101441-20200328-00165
- VernacularTitle:早卵泡期长效长方案最佳获卵数的探讨
- Author:
Junwei ZHANG
1
;
Manman LIU
1
;
Lijun SUN
1
;
Xingling WANG
1
;
Yichun GUAN
1
;
Yanli WU
1
;
Mingze DU
1
Author Information
1. 郑州大学第三附属医院生殖医学科 450052
- Publication Type:Journal Article
- Keywords:
Number of oocytes retrieved;
Cumulative live birth rate;
Ovarian hyperstimulation syndrome
- From:
Chinese Journal of Reproduction and Contraception
2021;41(4):307-312
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the optimal number of oocytes retrieved of early follicular phase prolonged protocol and to reduce the risk of ovarian hyperstimulation syndrome (OHSS) while achieving a high cumulative live birth rate (CLBR).Methods:It was a retrospective cohort study. Patients who underwent the first in vitro fertilization or intracytoplasmic sperm injection in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2014 to December 2017 were included. According to the number of oocytes retrieved, we divided all patients into 5 groups, group A: 1-5 oocytes, group B: 6-10 oocytes, group C: 11-15 oocytes, group D: 15-20 oocytes, group E: >20 oocytes. The basic and clinical data of 5 groups were analyzed. The main outcome measures were CLBR and the incidence of OHSS. Binary logistic regression was used to correct confounding factors to analyze the factors affecting the CLBR and the incidence of OHSS. We calculated the CLBR and the incidence of OHSS in each group. Results:The maternal age (a OR=0.93, 95% CI=0.90-0.97, P<0.001) and body mass index (a OR=0.95, 95% CI=0.92-0.99, P=0.02) were risk factors for CLBR. The number of oocytes retrieved was the protection factor for CLBR (a OR=1.27, 95% CI=1.20-1.35, P<0.001). The maternal age (a OR=0.94, 95% CI=0.91-0.97, P<0.001), body mass index (a OR=0.96, 95% CI=0.93-0.99, P=0.04), and increase in the number of oocytes retrieved (a OR=1.84, 95% CI=1.64-2.06, P<0.001) were the independent risk factors of the incidence of OHSS. With the increase of the number of oocytes retrieved (group A to group C), CLBR increased significantly [51.6% (157/304), 64.8% (869/1314), 75.2% (1334/1774), P<0.001], while the differences among groups C, D and E were not statistically significant ( P>0.05). With the increase in the number of oocytes retrieved (group A to group E), the incidence of OHSS increased significantly [0.3% (1/304), 3.3% (44/1314), 5.0% (88/1774), 9.8% (104/1065), 15.4% (77/499), P<0.001], especially when the number of oocytes retrieved was >15. Conclusion:For the early follicular phase prolonged protocol, the optimal number of oocytes retrieved is 11-15, which can obtain higher CLBR, and reduce the incidence of OHSS.
