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黄体期初始阶段给予促性腺激素释放激素激动剂(GnRH)可提高激素替代疗法(HRT)-冻融胚胎移植(FET)方案的临床结局:一项回顾性分析

Clinical Outcomes in Hormone Replacement Therapy (HRT)-Frozen Embryo Transfer (FET) Protocol Increased by Administering Gonadotropin-Releasing Hormone Agonist (GnRH) in the Initial Stage of the Luteal Phase: A Retrospective Analysis.

作者信息

Mahmood Aamir, Tan Li

机构信息

Reproductive Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, CHN.

出版信息

Cureus. 2024 Feb 8;16(2):e53877. doi: 10.7759/cureus.53877. eCollection 2024 Feb.

Abstract

OBJECTIVE

The objective of this study was to determine if gonadotropin-releasing hormone agonist (GnRH) administration supporting the luteal phase in frozen embryo transfer (FET) improves clinical outcomes Methods and materials This is a retrospective cohort study and we analyzed 3515 cycles of FET at the Department of Reproductive Medicine in our hospital from February 2018 through December 2021. Patients were divided into the GnRH (triptorelin+progesterone and human chorionic gonadotropin (hCG)) group and the non-GnRHa (existing treatment without triptorelin) group. There were 1033 and 2485 cases in the above groups, respectively. Live birth rates (LBR) and clinical pregnancy rates (CPR) were contrasted in the two groups.

RESULTS

We found greater CPR (58.00% versus 48.40%, P-value = 0.003) and LBR (52.70% versus 45.60%, P-value = 0.001) for HRT-FET cycles, and found no clinical significance for natural cycle FET (NC-FET) (58.20% versus 52.90%, P-value = 0.364 and 54.40% versus 47.00%, P-value=0.211), GnRH+HRT-FET (53.00% versus 53.00%, P-value=0.176 and 46.20% versus 47.30%, P-value=0.794), and stimulation-FET (59.30% versus 52.90%, P-value=.00.566 and 59.30% versus 47.10%, P-value=.00.247) in terms of CPR and LBR in the two groups. There was a 47% increase in CPR in the GnRH group, and there was a 33% increase in LBR in the same group.

CONCLUSION

During HRT-FET cycles, administering triptorelin three to four times in the existing luteal support can improve CPR and LBR, and administering triptorelin during the initial stage of the luteal phase can prove a new option for luteal support.

摘要

目的

本研究旨在确定在冻融胚胎移植(FET)中给予促性腺激素释放激素激动剂(GnRH)支持黄体期是否能改善临床结局。方法和材料:这是一项回顾性队列研究,我们分析了2018年2月至2021年12月在我院生殖医学科进行的3515个FET周期。患者被分为GnRH组(曲普瑞林+黄体酮和人绒毛膜促性腺激素(hCG))和非GnRHa组(不使用曲普瑞林的现有治疗方法)。上述两组分别有1033例和2485例。对比两组的活产率(LBR)和临床妊娠率(CPR)。

结果

我们发现激素替代疗法冻融胚胎移植(HRT-FET)周期的CPR(58.00%对48.40%,P值=0.003)和LBR(52.70%对45.60%,P值=0.001)更高,并且发现自然周期冻融胚胎移植(NC-FET)(58.20%对52.90%,P值=0.364和54.40%对47.00%,P值=0.211)、GnRH+HRT-FET(53.00%对53.00%,P值=0.176和46.20%对47.30%,P值=0.794)以及刺激周期冻融胚胎移植(stimulation-FET)(59.30%对52.90%,P值=0.00566和59.30%对47.10%,P值=0.00247)在两组的CPR和LBR方面无临床意义。GnRH组的CPR增加了47%,同一组的LBR增加了33%。

结论

在HRT-FET周期中,在现有黄体支持方案中给予曲普瑞林三到四次可提高CPR和LBR,在黄体期初期给予曲普瑞林可成为黄体支持的一种新选择。

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