Effect of low dosage of human chorionic gonadotropin in late follicular stage during progestin-primed ovarian stimulation on the outcome of in vitro fertilization for polycystic ovary syndrome patients
10.3760/cma.j.cn101441-20200105-00006
- VernacularTitle:高孕激素状态下促排卵治疗的卵泡晚期应用低剂量人绒毛膜促性腺激素对多囊卵巢综合征患者体外受精结局的影响
- Author:
Jing YE
1
;
Qiuju CHEN
1
;
Yonglun FU
1
;
Yanping KUANG
1
Author Information
1. 上海交通大学医学院附属第九人民医院辅助生殖科 200011
- Publication Type:Journal Article
- Keywords:
Progestin-primed ovarian stimulation;
Human chorionic gonadotropin;
Human menopausal gonadotropin;
Polycystic ovary syndrome
- From:
Chinese Journal of Reproduction and Contraception
2021;41(1):25-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of low dosage of human chorionic gonadotropin (hCG) replacing human menopausal gonadotropin (hMG) in the late follicular stage during progestin-primed ovarian stimulation (PPOS) on the outcome of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) for polycystic ovary syndrome (PCOS) patients. Methods:The patients with PCOS who underwent IVF/ICSI-frozen-thawed embryo transfer (FET) treatment in the Department of Assisted Reproduction of Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from March 2015 to December 2017 were retrospectively analyzed. Ovarian stimulation adopted PPOS. According to whether low dosage of hCG was used to replace hMG in the late follicular stage of PPOS, they were divided into two groups: group A, PPOS routine group (hMG + progesterone), complete application of hMG (141 cycles); group B, hMG/hCG+progesterone, low dosage of hCG (200 IU/d) was used to completely replace hMG in the late follicular stage of PPOS (80 cycles). The clinical data and pregnancy related indexes of the two groups were compared. The main outcome measures included the number of oocytes retrieved, the number of available embryos and clinical pregnancy rate.Results:There was no significant difference in the duration of ovarian stimulation between group A and group B [(9.7±2.6) d vs. (10.3±3.4) d, P=0.16]. The duration of hMG administration [(7.8±3.5) d] and the dosage of hMG [(1 592.8±840.5) IU] in group B were significantly lower than those in group A [(9.7±2.6) d, P=0.01; (1 825.2±795.3) IU, P=0.04]. There were no significant differences in the number of oocytes retrieved (17.3±8.9 vs.17.8±8.8) and the number of available embryos (6.2±4.1 vs. 6.0±3.2) between the two groups ( P>0.05). In the subsequent FET cycle, the clinical pregnancy rate [52.8% (105/199) vs. 49.2% (60/122)], the embryo implantation rate [37.1% (139/375) vs. 37.1% (86/232)], the early abortion rate [4.8% (5/105) vs. 5.0% (3/60)] and the ongoing pregnancy rate [47.7% (95/199) vs. 44.3% (54/122)] were not statistically different between group A and group B. Conclusion:The use of low dosage of hCG instead of hMG in the late follicular stage of PPOS in patients with PCOS, which can safely and effectively maintain follicular growth and development, without affecting the outcome of IVF/ICSI-FET for PCOS patients.
