Application of controlled ovarian hyperstimulation with agonist-antagonist protocol in POSEIDON group 3 and group 4 patients with low prognosis
10.3760/cma.j.cn101441-20210911-00409
- VernacularTitle:GnRH超短激动剂联合拮抗剂方案在POSEIDON低预后患者中的应用效果分析
- Author:
Yuanying LIU
1
;
Xiaoguo DU
1
;
Lixue CHEN
1
;
Rui YANG
1
;
Yongqing WANG
1
;
Ying WANG
1
;
Rong LI
1
;
Ping LIU
1
;
Jie QIAO
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心，国家妇产疾病临床研究中心（北京大学第三医院），辅助生殖教育部重点实验室（北京大学），北京市生殖内分泌与辅助生殖技术重点实验室，北京 100191
- Publication Type:Journal Article
- Keywords:
Gonadotropin-releasing hormone;
Ultrashort gonadotropin-releasing hormone agonist;
Gonadotropin-releasing hormone antagonist;
Poor ovarian response
- From:
Chinese Journal of Reproduction and Contraception
2022;42(9):942-947
- CountryChina
- Language:Chinese
-
Abstract:
Objective:By comparing standard gonadotropin-releasing hormone antagonist regimen and gonadotropin-releasing hormone agonist-antagonist protocol (AAP regimen) in Patient-Oriented Strategies Encompassing Individualized Oocyte Number (POSEIDON) group 3 and group 4 patients with low prognosis, to study if AAP regimen could improve the clinical outcomes in low prognosis patients.Methods:A case-control study was performed, the clinical data of 646 cycles of prospective poor ovarian response (POR) patients (POSEIDON group 3 and 4) who received in vitro fertilization and embryo transfer (IVF-ET) in Peking University Third Hospital Department of Obstetrics and Gynecology, Reproductive Medical Center from January 2016 to May 2018 were retrospectively analyzed. The total number of AAP cycle was 323, and control group was selected from the database with 1∶1 matching of contemporaneous prospective POR patients (POSEIDON group 3 and group 4) with similar age and approaching date of oocyte retrieval. Patients' general information, ovarian stimulation indexes and clinical outcomes were compared. Results:AAP group had fewer antral follicle count (AFC) [3.00(2.00,4.00) vs. 4.00(2.00,5.00), P<0.001] and similar anti-Müllerian hormone (AMH) level [0.51(0.25,0.83) μg/L vs. 0.53(0.31,0.81) μg/L, P>0.05] compared with control group. AAP group had shorter duration of gonadotropin (Gn) used [10.00(8.00,11.00) d vs. 10.00(9.00,11.00) d, P=0.020] and lower dosage of Gn used [2 675.00(2 100.00,3 300.00) U vs. 3 075.00(2 550.00,3 750.00) U, P<0.001] than control group. AAP group had similar number of oocytes obtained [3.00(2.00,5.00) vs. 4.00(2.00,6.00), P>0.05] compared with control group. Under the same proportion of fertilization schemes (routine or intracytoplasmic sperm injection methods), AAP group had higher fertilization rate [74.15% (955/1288) vs. 69.13% (918/1328), P=0.004] and good-quality embryo rate [62.57% (585/935) vs. 56.94% (509/894), P=0.014], and ultimately had higher embryo implantation rate [22.31% (87/390) vs. 15.84% (64/404), P=0.020], cumulative clinical pregnancy rate [32.50% (78/240) vs. 22.86% (56/245), P=0.018] and cumulative live birth rate [25.83% (62/240) vs. 17.96% (44/245), P=0.036]. Conclusion:For POSEIDON patients with low prognosis and POR, controlled ovarian hyperstimulation with AAP regimen had better clinical outcomes compared with conventional antagonist regimen.
