Reproductive Medicine Center, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Curr Med Sci. 2019 Jun;39(3):437-441. doi: 10.1007/s11596-019-2056-9. Epub 2019 Jun 17.
This study aimed to investigate the effect of different gonadotropin-releasing hormone agonist (GnRH-a) administration methods on pregnancy outcomes of patients undergoing in-vitro fertilization-embryo transfer (IVF-ET). Clinical data of 5217 patients who underwent IVF-ET were retrospectively analyzed. Patients were divided into the long-acting GnRH-a group (n=1330) and the short-acting GnRH-a group (n=3887) based on their various treatment plans. The clinical and laboratory embryo data and clinical pregnancy outcomes were compared between the two groups. The results showed that there were no significant differences in the age, infertility, primary/secondary infertility rate, IVF rate, body mass index (BMI), antral follicle counting (AFC), follicle-stimulating hormone (FSH) level, and the number of transplanted embryos between the two groups (P>0.05). There were no significant differences in the oocyte numbers, MII rate, fertilization rate, cleavage rate and blastocyst formation rate (P>0.05) between the two groups. The gonadotropin (Gn) using days, Gn dose and endometrial thickness were significantly greater in the long-acting GnRH-a group than those in the short-acting GnRH-a group (P<0.01). Additionally, the estradiol (E2) levels, blastocyst freezing rate, embryo utilization rate, transplant cancellation rate and abortion rate were significantly lower in the long-acting GnRH-a group than those in the short-acting GnRH-a group (P<0.01). The clinical pregnancy rate and embryo implantation rate were significantly higher in the long-acting GnRH-a group than in the short-acting GnRH-a group (P<0.01). It was concluded that use of long-acting GnRH-a can effectively reduce the transplant cancellation rate and improve the clinical pregnancy rate of the fresh cycle.
本研究旨在探讨不同促性腺激素释放激素激动剂(GnRH-a)给药方式对体外受精-胚胎移植(IVF-ET)患者妊娠结局的影响。回顾性分析了 5217 例接受 IVF-ET 的患者的临床资料。根据不同的治疗方案,将患者分为长效 GnRH-a 组(n=1330)和短效 GnRH-a 组(n=3887)。比较两组患者的临床和实验室胚胎数据及临床妊娠结局。结果显示,两组患者的年龄、不孕年限、原发/继发不孕率、IVF 率、体质量指数(BMI)、窦卵泡计数(AFC)、卵泡刺激素(FSH)水平、移植胚胎数比较,差异均无统计学意义(P>0.05)。两组患者的获卵数、MⅡ 卵率、受精率、卵裂率、囊胚形成率比较,差异均无统计学意义(P>0.05)。长效 GnRH-a 组的促性腺激素(Gn)使用天数、Gn 剂量和子宫内膜厚度均显著大于短效 GnRH-a 组(P<0.01)。此外,长效 GnRH-a 组的雌二醇(E2)水平、囊胚冷冻率、胚胎利用率、移植取消率和流产率均显著低于短效 GnRH-a 组(P<0.01)。长效 GnRH-a 组的临床妊娠率和胚胎着床率均显著高于短效 GnRH-a 组(P<0.01)。结论:使用长效 GnRH-a 可有效降低移植取消率,提高新鲜周期的临床妊娠率。