Effect of the duration of gonadotropin stimulation on pregnancy outcome of in vitro fertilization and embryo transfer with GnRH-a long protocol
10.3760/cma.j.cn101441-20240116-00027
- VernacularTitle:促性腺激素使用时长对促性腺激素释放激素激动剂长方案体外受精-胚胎移植妊娠结局的影响
- Author:
Hongxia ZHANG
1
;
Shuo YANG
1
;
Tian TIAN
1
;
Xiumei ZHEN
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心 女性生育力促进全国重点实验室 国家妇产疾病临床医学研究中心（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北京市重点实验室，北京100191
- Publication Type:Journal Article
- Keywords:
Gonadotropin;
Reproductive technology, assisted;
Fertilization in vitro;
Luteal phase long protocol;
Pregnancy outcome
- From:
Chinese Journal of Reproduction and Contraception
2024;44(9):898-905
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of gonadotropin (Gn) stimulation duration on the pregnancy outcome in both fresh and frozen embryo transfer cycles in patients underwent in vitro fertilization (IVF) with gonadotrophin-releasing hormone agonist (GnRH-a) long protocol. Methods:A retrospective cohort study was used to analyze the clinical data of patients who underwent IVF/intracytoplasmic sperm injection (ICSI) with GnRH-a long protocol in Reproductive Medicine Center, Department of Obstetrics and Gynecology of Peking University Third Hospital from January 2017 to December 2021. According to the duration of Gn used in controlled ovarian stimulation, they were divided into two groups (Gn stimulation duration>15 d group, 1 198 cases; Gn stimulation duration≤15 d group, 4 792 cases), the general information and pregnancy outcome between the two groups were compared, and multiple factors binary logistic regression was used to control confounding factors and analyze the relationship between Gn stimulation duration and live birth.Results:In the fresh cycles, the rate of non-transplantable embryos in the group of Gn stimulation duration>15 d [16.4% (195/1 187)] was significantly higher than that in the group of Gn stimulation duration≤15 d group [7.1% (338/4 757), P<0.001], but there were no statistical differences in clinical pregnancy rate, live birth rate, implantation rate and early spontaneous abortion rate between the two groups (all P>0.05). In the frozen cycles, there were no statistical differences in clinical pregnancy rate, live birth rate, embryo implantation rate and early abortion rate between the two groups (all P>0.05). Multiple factors binary logistic analysis showed that there was no significant correlation between Gn stimulation duration and live birth in both fresh and frozen cycles ( P=0.432, P=0.856). Conclusion:Compared with the group of Gn stimulation duration≤15 d in patients with GnRH-a protocol, there was an increase in the rate of non-transplantable embryos in the fresh cycles in the group of Gn stimulation duration>15 d. However, once transferable embryos were available, pregnancy outcomes were similar in fresh and thawed cycles, and no effect on pregnancy outcomes in fresh cycles by affecting endometrial tolerance was observed.
