Reproductive Medicine Center, Renmin Hospital, Hubei University of Medicine, Shiyan, China.
Hubei Clinical Research Center for Reproductive Medicine, Shiyan, China.
Front Endocrinol (Lausanne). 2024 Jun 28;15:1414213. doi: 10.3389/fendo.2024.1414213. eCollection 2024.
To explore the impact of the level of differentiation in a minimum of two follicles with a diameter of ≥18 mm on the outcome of controlled ovarian hyperstimulation on the day of human chorionic gonadotropin (hCG) administration.
Single-center data from January 2018 to December 2021 was retrospectively analyzed for 1,199 patients with fresh embryo transfer for assisted reproduction. The absolute value of the standard deviation of the follicle size of at least 2 follicles ≥18 mm in diameter in both ovaries on the day of hCG was taken as the degree of differentiation of the dominant follicle after ovulation induction, based on the standard deviation response to the degree of dispersion of the data. The degree of follicular differentiation was divided into 3 groups according to the size of the value, and the general clinical conditions, laboratory indexes, and clinical outcomes of the patients in the 3 groups were compared.
Among the three groups, the body mass index (BMI) of the ≤1s group was lower than that of the other two groups (P< 0.05), while the follicle-stimulating hormone (FSH) and Anti-Mullerian hormone (AMH) were higher (P< 0.05), and the implantation rate and clinical pregnancy rate were significantly higher than those of the other two groups (P< 0.01). After multifactorial logistic regression to correct for confounding factors, with the ≤1s group as the reference, the implantation rate, hCG-positive rate, clinical pregnancy rate and live birth rate of embryo transfer in the ≥2S group were significantly lower (P< 0.01). The results of curve fitting analysis showed that the live birth rate decreased gradually with the increase of the absolute standard deviation (P=0.0079).
Differences in follicle diameters ≥18 mm on the day of hCG injection did not have an impact on embryo quality, but had an impact on pregnancy outcomes. The less the variation in follicle size, the more homogeneous the follicle development and the higher the likelihood of live births.
探讨人绒毛膜促性腺激素（hCG）注射日至少两个≥18mm 卵泡直径的分化程度对控制性卵巢超促排卵结局的影响。
回顾性分析 2018 年 1 月至 2021 年 12 月行新鲜胚胎移植的 1199 例接受辅助生殖治疗患者的单中心数据。以 hCG 注射日双侧卵巢至少 2 个≥18mm 卵泡直径的卵泡大小标准差的绝对值作为排卵诱导后优势卵泡的分化程度，根据标准差反应数据的离散度大小将卵泡分化程度分为 3 组，比较 3 组患者的一般临床情况、实验室指标和临床结局。
在这 3 组中，≤1s 组的体质量指数（BMI）低于其他两组（P<0.05），而卵泡刺激素（FSH）和抗苗勒管激素（AMH）水平更高（P<0.05），其种植率和临床妊娠率明显高于其他两组（P<0.01）。经多因素逻辑回归校正混杂因素后，以≤1s 组为参照，≥2s 组的胚胎移植种植率、hCG 阳性率、临床妊娠率和活产率均明显降低（P<0.01）。曲线拟合分析结果显示，活产率随绝对标准差的增加而逐渐降低（P=0.0079）。
hCG 注射日≥18mm 卵泡直径的差异并不影响胚胎质量，但影响妊娠结局。卵泡大小的变异越小，卵泡发育越均匀，活产的可能性越高。
