Clinical outcomes of long agonist protocol in predicted hyper responders and the risk factors associated with hyper ovarian response
10.3760/cma.j.cn101441-20200315-00132
- VernacularTitle:卵泡期长效长方案在符合卵巢高反应预测指标患者中的运用及其发生高反应的危险因素分析
- Author:
Zhanghong KE
1
;
Yan SUN
1
;
Lirong LIU
1
;
Xiaoming LIN
1
;
Beihong ZHENG
1
Author Information
1. 福建省妇幼保健院生殖中心，福建医科大学附属医院，福建省生殖医学中心，福州 350001
- Publication Type:Journal Article
- Keywords:
Ovarian stimulation;
Luteinizing hormone;
Long agonist protocol;
Hyper ovarian response
- From:
Chinese Journal of Reproduction and Contraception
2021;41(3):199-205
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To investigate the clinical outcomes of long agonist protocol in predicted hyper responders, and to explore the risk factors associated with hyper ovarian response in these patients.Methods:In this retrospective case-control study, 664 predicted hyper responders were included. All patients were from Reproductive Center of Fujian Maternity and Child Health Hospital, and were in treatment during January 1, 2016 and June 1, 2019. Logistic regression was applied to screen out the independent risk factors of hyper ovarian response. The prediction accuracy of the independent risk factors was evaluated by calculating the area under the receiver operating characteristic curve (AUC).Results:Totally 10 (1.51%) of all patients occurred poor ovarian response, 356 (53.61%) of all patients achieved normal ovarian response, and 298 (44.88%) of them got hyper ovarian response. The rate of moderate-to-severe ovarian hyperstimulation syndrom (OHSS) from normal response group [3.09% (11/356)] was significantly lower than that from hyper response group [8.39% (25/298), P=0.003]. The rate of clinical pregnancy per transfer showed no statistical significance between the two groups ( P>0.05). The miscarriage rate was more than two times in normal response group compared with high response group, but without statistical significance ( P>0.05). Multivariate logistic regression analysis showed that luteinizing hormone (LH) level on human chorionic gonadotropin (hCG) injection day was negatively correlated with the occurrence of hyper ovarian response. The AUC of LH level on hCG injection day was 0.594. LH level on hCG injection day ≤1.0 IU/L was an independent risk factor of hyper ovarian response. Conclusion:Long agonist protocol is a good option for predicted hyper responders. LH supplementation might be helpful in controlled ovarian stimulation to reduce the incidence of hyper ovarian response.
