Embryo transfer strategies of early follicular phase prolonged protocol
10.3760/cma.j.cn101441-20200402-00182
- VernacularTitle:早卵泡期长效长方案的胚胎移植策略
- Author:
Junwei ZHANG
1
;
Bingnan REN
1
;
Sheling WU
1
;
Yanli WU
1
;
Jijun HU
1
;
Manman LIU
1
;
Lijun SUN
1
;
Xingling WANG
1
;
Yichun GUAN
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:
Blastocyst;
Embryo;
Multiple birth;
Live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2021;41(7):618-623
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the embryo transfer strategies of early follicular phase prolonged protocol, to reduce the risk of multiple birth rate while achieving a higher live birth rate.Methods:It was a retrospective cohort study. Patients who underwent gonadotropin-releasing hormone (GnRH) agonist protocols in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2017 to February 2019 were included. According to the type of embryos transferred, we divided all cycles into four groups, fresh cycle cleavage stage embryo transfer group (group A), fresh cycle blastocyst transfer group (group B), freeze-thaw cleavage stage embryo transfer group (group C), freeze-thaw blastocyst transfer group (group D). The main outcome measures were live birth rate and multiple birth rate. Binary logistic regression was used to correct confounding factors.Results:The risk of moderate to severe ovarian hyperstimulation syndrome (OHSS) in group A [4.8% (110/2283)] was higher than that in group C [1.0% (6/614), P<0.001] and group D [2.1% (16/762), P<0.001]. The risk of moderate to severe OHSS in group B [3.8% (42/1116)] was higher than that in group C ( P<0.001). The multiple birth rate of the two embryos transfer group [group A 23.4% (535/2283), group C 20.8% (128/614) ] was significantly higher than that of the one blastocyst transfer group [group B 1.4% (16/1116), group D 0.9% (7/762)], and the difference was statistically significant ( P<0.001). The clinical pregnancy rate [68.7% (767/1116)] and the live birth rate [59.6% (665/1116)] of group B were higher than those of group A [63.5% (1449/2283), P=0.003; 54.8% (1250/2283), P=0.008], group C [60.1% (369/614), P<0.001; 51.6% (317/614), P=0.001] and group D [62.7% (478/762), P=0.007; 52.8% (402/762), P=0.003], but there was no statistical difference among group A, group C and group D. Taking group B as a reference, the live birth rate of group A (a OR=0.86, 95% CI=0.74-0.99, P=0.044), group C (a OR=76, 95% CI=0.62-0.93, P=0.008) and group D (a OR=0.79, 95% CI=0.65-0.95, P=0.013) was lower than that of group B. Conclusion:For the early follicular phase prolonged protocol, based on the control of OHSS, fresh cycle single blastocyst transplantation is preferred. While obtaining a higher live birth rate, the multiple birth rate is significantly reduced.
