Follicular phase long-acting gonadotropin-releasing hormone agonist long protocol could improve IVF/ICSI outcomes of patients with endometriosis
10.3760/cma.j.cn101441-20201019-00571
- VernacularTitle:卵泡期长效长方案改善子宫内膜异位症患者IVF/ICSI的临床结局
- Author:
Wenshu LI
1
;
Hongchu BAO
1
;
Wei ZHANG
1
;
Huishan ZHAO
1
;
Xuemei LIU
1
Author Information
1. 青岛大学附属烟台毓璜顶医院生殖医学中心 266000
- Publication Type:Journal Article
- Keywords:
Endometriosis;
Fertilization in vitro;
Long-acting gonadotropin-releasing hormone agonist;
Clinical pregnancy rate
- From:
Chinese Journal of Reproduction and Contraception
2021;41(6):496-502
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of follicular phase long-acting gonadotropin-releasing hormone (GnRH) agonist long protocol on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes of patients with endometriosis (EMS). Methods:This retrospective cohort study was carried out from July 1st 2015 to June 30th 2019 and enrolled 383 young patients with EMS who underwent the first IVF/ICSI. According to the controlled ovarian hyperstimulation protocols, patients were classified into three groups: follicular phase long-acting GnRH agonist long protocol group (group A), short-acting GnRH agonist long protocol group (group B) and GnRH antagonist protocol group (group C). The clinical outcomes of IVF/ICSI were compared among the groups by using univariate and multivariate logistic regression analyses.Results:The patients with EMS in group A had significantly higher duration of stimulation and total dosage of gonadotrophin (Gn) used [11 (9,13) d, 2700 (2250, 3200) IU] than those in group B and group C [9 (8,10) d, 1875 (1575, 2250) IU; 8 (8,9) d, 1800 (1425, 2250) IU] (all P<0.001). Serum levels of luteinizing hormone (LH) [0.64 (0.35, 0.99) IU/L vs. 1.78 (1.42, 2.05) IU/L vs. 5.00 (3.63, 6.46) IU/L; 0.89 (0.37, 1.33) IU/L vs. 2.48 (1.76, 3.25) IU/L vs. 2.46 (1.66, 3.67) IU/L] and estradiol [6.70 (5.00,16.90) μg/L vs. 7.93 (6.50, 7.93) μg/L vs. 34.05 (22.99, 45.58) μg/L; 1.82 (1.11, 2.75) μg/L vs. 2.97 (2.16,4.24) μg/L vs. 2.03 (1.49, 2.96) μg/L) on Gn initiation day and human chorionic gonadotropin (hCG) injection day were significantly lower in group A (all P<0.001). Group A had significantly higher clinical pregnancy rate [76.53% (75/98)], implantation rate [54.10% (99/183)] and live birth rate [66.33% (65/98)] compared with those in group B and group C [61.39% (62/101) and 54.39% (31/57), P=0.010; 42.63% (81/190), and 40.19% (43/107), P=0.029; 53.47% (54/101), and 47.37% (27/57), P=0.046]. Conclusion:Follicular phase long-acting GnRH agonist protocol could improve IVF/ICSI outcomes of patients with EMS compared with short-acting GnRH agonist long protocol and GnRH antagonist protocol.
