A propensity score matching study of oral contraceptive pretreatment on the live birth rate of modified long down-regulation protocol in in vitro fertilization and embryo transfer and intracytoplasmic sperm injection cycles
10.3760/cma.j.cn101441-20200109-00017
- VernacularTitle:口服避孕药预处理对改良长方案体外受精/卵胞质内单精子显微注射活产率影响的一项倾向评分匹配研究
- Author:
Junwen ZHANG
1
;
Jiali CAI
1
;
Lanlan LIU
1
;
Jianzhi REN
1
;
Aiguo SHA
1
Author Information
1. 中国人民解放军陆军第七十三集团军医院生殖中心，厦门 361003
- Publication Type:Journal Article
- Keywords:
Contraceptive oral;
Pregnancy rate;
Live birth rate;
Modified long down-regulation protocol
- From:
Chinese Journal of Reproduction and Contraception
2021;41(2):106-112
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of oral contraceptive pretreatment on pregnancy outcome of modified long down-regulation protocol in in vitro fertilization and embryo transfer and intracytoplasmic sperm injection cycles. Methods:Totally 13 542 cycles were retrospectively analyzed in Reproductive Medicine Center of the 73th Group Military Hospital of PLA from January 2012 to December 2017. According to whether use oral contraceptives (OC) before down-regulation, they were divided into OC group (591 cases) and non-OC group (12 951 cases). After the variables between the two groups were balanced by the propensity score matching method, the number of oocytes obtained, number of mature oocytes, number of fertilized oocytes, number of high-quality embryos, estradiol level on human chorionic gonadotropin (hCG) trigger day, endometrial thickness on hCG trigger day, the clinical pregnancy rate and the live birth rate of the two groups were compared.Results:Before matching, the estradiol level on hCG triger day in OC group [3 118.00(2 529.00) ng/L] was lower than that in non-OC group [3 422.00(2 733.00) ng/L], with statistically significant difference ( P=0.001), there was no significant difference between OC group and non-OC group in the number of harvested oocytes and mature oocytes, fertilization number, number of viable embryos, endometrial thickness on hCG trigger day, the clinical pregnancy rate and the live birth rate. However, after adjusting for confounding factors through multi-factor logistics regression analysis, OC group was the negative factor to reduce the live birth rate compared with non-OC group (clinical pregnancy rate OR=0.83, 95% CI=0.68-1.02; live birth rate OR=0.82, with 95% CI=0.88-0.99). After matching, the clinical pregnancy rate and the live birth rate of OC group and non-OC group had no statistically significant differences (clinical pregnancy rate OR=0.94, 95% CI=0.75-1.14, P=0.59; live birth rate OR=0.91, 95% CI=0.74-1.13, P=0.38). A post-hoc power caculation demonstrated that the study sample size yielded >80% power to detect a no less than 3.7% difference between groups in the primary outcome. Conclusion:The pretreatment of oral contraceptives has no significant effect on the outcome of modified long down-regulation protocol.
