Reproductive Medical Center, Henan Province Key Laboratory for Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Endocrinol (Lausanne). 2023 Jun 19;14:1186146. doi: 10.3389/fendo.2023.1186146. eCollection 2023.
The objective of this study was to explore whether the duration of LFEP (late-follicular elevated progesterone) affected pregnancy outcomes in IVF ( fertilization) patients treated with pituitary downregulation protocols.
Patients with their first IVF/ICSI cycles between January 2016 and December 2016 were included. LFEP was set either at P > 1.0ng/ml or P > 1.5ng/ml. Clinical pregnancy rate was compared among three different groups (no LFEP; LFEP for 1 day; LFEP for ≥ 2 days). Then multivariate logistic regression analysis was performed to explore the influencing factors of clinical pregnancy rate.
This retrospective analysis involved 3,521 first IVF/ICSI cycles with fresh embryo transfers. Clinical pregnancy rate was the lowest in patients with a LFEP duration of ≥ 2 days, irrespective of whether LFEP was defined as P > 1.0 ng/ml (68.79% vs. 63.02% vs. 56.20%; = 0.000) or as P > 1.5 ng/ml (67.24% vs. 55.95% vs. 45.51%; = 0.000). In addition, LFEP duration was significantly associated with clinical pregnancy outcomes in unadjusted logistic regression analysis. However, in multivariate regression models after adjusting confounders, adjusted OR for LFEP duration (≥ 2 days) in the two models was 0.808 ( = 0.064; LFEP as P > 1.0 ng/ml) and 0.720 ( = 0.098; LFEP as P > 1.5 ng/ml), respectively.
LFEP adversely affects clinical pregnancy outcomes. However, the duration of LFEP seems to have no influence on the clinical pregnancy rate in pituitary downregulation treatment cycles.
本研究旨在探讨黄体期延长（晚卵泡期孕酮升高）对接受垂体下调方案的体外受精（IVF）患者妊娠结局的影响。
纳入 2016 年 1 月至 12 月期间行首次 IVF/ICSI 周期的患者。黄体期孕酮设定为 P＞1.0ng/ml 或 P＞1.5ng/ml。比较无黄体期延长（LFEP）、LFEP 持续 1 天、LFEP 持续≥2 天的三组间临床妊娠率。然后进行多变量 logistic 回归分析，以探讨临床妊娠率的影响因素。
本回顾性分析共纳入 3521 例新鲜胚胎移植的首次 IVF/ICSI 周期。LFEP 持续时间≥2 天的患者临床妊娠率最低，无论黄体期孕酮定义为 P＞1.0ng/ml（68.79%比 63.02%比 56.20%；P=0.000）还是 P＞1.5ng/ml（67.24%比 55.95%比 45.51%；P=0.000），差异均有统计学意义。此外，LFEP 持续时间与未校正 logistic 回归分析中的临床妊娠结局显著相关。然而，在调整混杂因素后的多变量回归模型中，两个模型中 LFEP 持续时间（≥2 天）的调整比值比（OR）分别为 0.808（P=0.064；黄体期孕酮 P＞1.0ng/ml）和 0.720（P=0.098；黄体期孕酮 P＞1.5ng/ml）。
LFEP 对临床妊娠结局有不良影响。然而，在垂体下调治疗周期中，LFEP 的持续时间似乎对临床妊娠率没有影响。
