Center for Advanced Reproductive Services, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT, USA.
J Assist Reprod Genet. 2020 Mar;37(3):611-617. doi: 10.1007/s10815-019-01646-z. Epub 2020 Jan 2.
To assess whether GnRH agonist trigger impacts the implantation potential of euploid embryos.
Retrospective cohort study done at an academic IVF center evaluating frozen-thawed embryo transfer (FET) cycles in which single-euploid blastocysts were transferred between 2014 and 2019. All embryos were generated in an IVF cycle which used GnRHa or hCG trigger and then were transferred in a programmed or natural FET cycle. Only the first FET cycle was included for each patient. Primary outcome was ongoing pregnancy rate or live birth rate (OPR/LBR). Secondary outcomes were implantation rate (IR), clinical pregnancy rate (CPR), clinical loss rate (CLR), and multiple pregnancy rate (MPR). Logistic regression was performed to control for confounding variables. A p value of < 0.05 was considered statistically significant.
Two hundred sixty-three FET cycles were included for analysis (GnRHa = 145; hCG = 118). The GnRHa group was significantly younger (35.2 vs. 37.5 years) and had higher AMH values (4.50 ng/ml vs. 2.03 ng/ml) than the hCG group, respectively (p < 0.05). There was no significant difference in OPR/LBR (64.1% (93/145) vs. 65.3% (77/118); p = 0.90) between the GnRHa and hCG groups, respectively. There was also no significant difference in IR, CPR, CLR, or MPR between groups. After controlling for confounding variables, the adjusted odds ratio for OPR/LBR was 0.941 (95% CI, 0.534-1.658); p = 0.83) comparing GnRHa to hCG. Pregnancy outcomes did not significantly differ when groups were stratified by age (< 35 vs. > 35 years old).
Our findings confirm that euploid embryos created after hCG or GnRHa trigger have the same potential for pregnancy.
评估 GnRH 激动剂触发是否会影响整倍体胚胎的着床潜能。
这是一项在学术型体外受精 (IVF) 中心进行的回顾性队列研究，评估了 2014 年至 2019 年间进行的冻融胚胎移植 (FET) 周期中单枚整倍体囊胚移植。所有胚胎均在使用 GnRH 激动剂或 hCG 触发的 IVF 周期中生成，然后在程序化或自然 FET 周期中进行移植。每位患者仅纳入第一个 FET 周期。主要结局是持续妊娠率或活产率 (OPR/LBR)。次要结局是着床率 (IR)、临床妊娠率 (CPR)、临床丢失率 (CLR)和多胎妊娠率 (MPR)。采用逻辑回归控制混杂变量。p 值<0.05 被认为具有统计学意义。
共纳入 263 个 FET 周期进行分析 (GnRHa=145; hCG=118)。GnRHa 组患者明显更年轻 (35.2 岁 vs. 37.5 岁)，AMH 值更高 (4.50ng/ml vs. 2.03ng/ml)，差异均具有统计学意义 (p<0.05)。GnRHa 组和 hCG 组的 OPR/LBR 分别为 64.1%(93/145)和 65.3%(77/118)，差异无统计学意义 (p=0.90)。两组间 IR、CPR、CLR 或 MPR 亦无显著差异。调整混杂变量后，GnRHa 组与 hCG 组比较，OPR/LBR 的调整优势比为 0.941(95%CI，0.534-1.658;p=0.83)。按年龄(<35 岁与>35 岁)分层比较时，妊娠结局无显著差异。
本研究结果证实，hCG 或 GnRH 激动剂触发后产生的整倍体胚胎具有相同的妊娠潜能。
