Effect of trigger timing on clinical outcomes of low prognosis patients with gonadotropin-releasing hormone antagonist
10.3760/cma.j.cn101441-20201027-00582
- VernacularTitle:低预后人群拮抗剂方案中不同扳机时机对临床结局的影响
- Author:
Jianing XU
1
;
Cuilian ZHANG
1
;
Yisha YIN
1
;
Shuna WANG
1
;
Shaodi ZHANG
1
Author Information
1. 郑州大学人民医院，河南大学人民医院，河南省人民医院生殖中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Cumulative live birth rate;
Cumulative pregnancy rate;
Low prognosis;
Gonadotropin-releasing hormone antagonist;
Trigger timing
- From:
Chinese Journal of Reproduction and Contraception
2022;42(5):447-454
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of altering trigger timing on clinical outcomes of low prognosis patients with gonadotropin-releasing hormone (GnRH) antagonist.Methods:A retrospective cohort study was conducted on 1613 cycles of low prognosis patients based on POSEIDON criteria undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH antagonist protocol between January 2017 to June 2019 in Reproductive Medicine Center, Henan Provincial People's Hospital. Patients were divided into 3 groups depending on different trigger timing criteria (conventional trigger group, n=961; advanced trigger group, n=359; delayed trigger group, n=293). Univariate analysis and multivariate logistic regression analysis were used to analyze the effect of trigger timing on clinical outcomes such as cumulative pregnancy rate (CPR) and cumulative live birth rate (CLBR) among different groups. Results:The clinical pregnancy rate of fresh cycle in advanced trigger group, conventional trigger group, delayed trigger group were 35.77% (44/123), 39.16% (150/383), 34.01% (50/147), respectively. CPR and CLBR ranked from low to high in order of advanced trigger group, conventional trigger group and delayed trigger group [CPR: 33.18% (72/217) vs. 42.23% (276/652) vs. 45.27% (91/201), P=0.024; CLBR: 22.97% (48/209) vs. 31.96% (201/629) vs. 35.90% (70/159), P=0.012]. The result of multivariate logistics regression analysis showed that there were no significant differences on clinical pregnancy rate, CPR and CLBR among three groups [delayed trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.69(0.44-1.09), P=0.114; CPR OR(95% CI)=0.77 (0.51-1.16), P=0.214; CLBR OR(95% CI)=0.83(0.54-1.29), P=0.418; advanced trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.98(0.60-1.60), P=0.934; CPR OR(95% CI)=0.87(0.58-1.30), P=0.513; CLBR OR(95% CI)=0.86(0.54-1.35), P=0.515]. Conclusion:Conventional trigger could obtain the ideal clinical outcomes in low prognosis patients based on P
