Reproductive Medicine Center, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Guangdong Provincial Key Laboratory of Reproductive Medicine, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Endocrinol (Lausanne). 2021 Oct 21;12:738005. doi: 10.3389/fendo.2021.738005. eCollection 2021.
To investigate the impact of luteinized unruptured follicles (LUF) on clinical outcomes of frozen/thawed embryo transfer (FET) of blastocysts.
In this retrospective cohort study, 2,192 patients who had undergone blastocyst FET treatment with natural cycles from October 2014 to September 2017 were included. Using propensity score matching, 177 patients diagnosed with LUF (LUF group) were matched with 354 ovulating patients (ovulation group). The LUF group was further stratified by the average LH peak level of 30 IU/L. Clinical pregnancy rate and live birth rate were retrospectively analyzed between the LUF and ovulation groups, as well as between LUF subgroups.
After propensity score matching, general characteristics were similar in the LUF and ovulation groups. Clinical pregnancy rate in the LUF group was significantly lower than that in the ovulation group (47.46 58.76%, respectively, adjusted = 0.01, OR 0.60, 95% CI 0.42-0.87). However, no significant difference was detected in live birth rate, although it was lower in the LUF group (43.50 50.00%, adjusted = 0.19, OR 0.76, 95% CI 0.51-1.14). In the LUF subgroup analysis, both clinical pregnancy rate (43.02 62.30%, adjusted = 0.02, OR 0.45, 95% CI 0.23-0.87) and live birth rate (37.21 59.02%, adjusted = 0.01, OR 0.40, 95% CI 0.20-0.78) in the LH <30 IU/L subgroup were significantly lower than those in the LH ≥30 IU/L subgroup.
LUF negatively affected clinical outcomes of frozen/thawed embryo transfer of blastocysts, particularly when the LH surge was inadequate.
探讨黄素化未破裂卵泡（LUF）对冻融胚胎移植（FET）中囊胚临床结局的影响。
本回顾性队列研究纳入了 2014 年 10 月至 2017 年 9 月期间接受自然周期囊胚 FET 治疗的 2192 例患者。采用倾向评分匹配法，将 177 例诊断为 LUF（LUF 组）的患者与 354 例排卵患者（排卵组）进行匹配。LUF 组根据平均 LH 峰值 30 IU/L 进一步分层。回顾性分析 LUF 组和排卵组之间，以及 LUF 亚组之间的临床妊娠率和活产率。
在倾向评分匹配后，LUF 组和排卵组的一般特征相似。LUF 组的临床妊娠率显著低于排卵组（分别为 47.46%和 58.76%，校正后 = 0.01，OR 0.60，95%CI 0.42-0.87）。然而，活产率虽在 LUF 组较低，但差异无统计学意义（分别为 43.50%和 50.00%，校正后 = 0.19，OR 0.76，95%CI 0.51-1.14）。在 LUF 亚组分析中，LH<30 IU/L 亚组的临床妊娠率（43.02%和 62.30%，校正后 = 0.02，OR 0.45，95%CI 0.23-0.87）和活产率（37.21%和 59.02%，校正后 = 0.01，OR 0.40，95%CI 0.20-0.78）均显著低于 LH≥30 IU/L 亚组。
LUF 对冻融胚胎移植中囊胚的临床结局产生负面影响，特别是在 LH 激增不足时。
