Analysis of cumulative live birth rate of three controlled ovarian hyperstimulation protocols in POSEIDON patients with low prognosis
10.3760/cma.j.cn101441-20200908-00488
- VernacularTitle:三种促排卵方案在波塞冬低预后患者中的累积活产率分析
- Author:
Junwei ZHANG
1
;
Mingze DU
1
;
Lijun SUN
1
;
Yichun GUAN
1
Author Information
1. 郑州大学第三附属医院生殖医学中心，郑州 450052
- Publication Type:Journal Article
- Keywords:
POSEIDON criteria;
Low prognosis;
Fertilization in vitro;
Embryo transfer;
Cumulative live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2022;42(2):117-124
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the cumulative live birth rate (CLBR) of gonadotropin-releasing hormone (GnRH) antagonist protocol, medroxyprogesterone (MPA) protocol and clomiphene citrate (CC) protocol in low prognosis population with decreased ovarian reserve.Methods:It was a retrospective cohort study. Patients who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from January 2015 to May 2018 were recruited. Including POSEIDON group 3 and group 4, GnRH-antagonist protocol, MPA, and CC protocol were used for ovulation stimulation. The basic data and clinical outcomes of the three protocols were analyzed. The main outcome measure was CLBR. With the GnRH-antagonist group as the reference, the adjusted odds ratio ( aOR) and 95% confidence interval ( CI) of the MPA group and the CC group were calculated. Results:In the POSEIDON group 3, the CLBR of the three protocols was not statistically different. After logistic regression analysis, the ovulation stimulation protocols did not affect the CLBR of POSEIDON 3 group ( P=0.226, P=0.468). In the POSEIDON group 4, the CLBR of the MPA group was higher than that of the CC group (10.7% vs. 5.4%, P=0.002). Using binary logistic regression and GnRH-antagonist group as the control, the CLBR of the MPA protocol was higher (a OR=2.22, 95% CI=1.17-4.24, P=0.021), the CLBR of the CC protocol was not significantly different from the GnRH-antagonist group (a OR=0.95, 95% CI=0.48-1.85, P=0.868). Conclusion:For patients under 35 years old with low ovarian reserve, the clinical outcomes of the three ovulation stimulation protocols were similar. For patients who are 35 years or older with low ovarian reserve, the CLBR of the MPA protocol was higher.
