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长卵泡期方案与拮抗剂方案对新鲜周期或冻融周期胚胎移植妊娠结局的疗效比较。

Comparison of efficacy of long follicular phase regimen and antagonist regimen on pregnancy outcome of fresh cycle or freeze-thawed cycle embryo transfer.

作者信息

Li Pengtao, Zhai Jiawei, Liu Ting, Guo Mengyuan, Wang Yuzhen

机构信息

Pengtao Li, Department of Reproductive Medicine, Baoding Maternal and Child Health Care Hospital, Baoding 071000, Hebei, China.

Jiawei Zhai, Department of Reproductive Medicine, Baoding Maternal and Child Health Care Hospital, Baoding 071000, Hebei, China.

出版信息

Pak J Med Sci. 2024 Nov;40(10):2170-2175. doi: 10.12669/pjms.40.10.9050.

DOI:10.12669/pjms.40.10.9050
PMID:39554641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11568699/
Abstract

OBJECTIVE

To compare the pregnancy outcome of the fresh cycle or freeze-thaw cycle embryo transfer of patients treated with a long follicular phase regimen and antagonist regimen, and explore the clinical therapeutic effect of the two regimens.

METHODS

This was a retrospective study. The data of a total of 543 patients who underwent in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) or frozen-thawed embryo transfer (FET) in Baoding Maternal and Child Health Care Hospital from January 2020 to December 2022 were retrospectively analyzed in this study and were divided into four group to analyze the basic conditions, medication, laboratory indicators and clinical outcomes after embryo transfer of patients in each group.

RESULTS

The pregnancy rate and implantation rate in Groups A, B and C were higher than those in Group-D, and the differences were statistically significant (0.05). The difference in multiple pregnancy rate and abortion rate among groups was not statistically significant (0.05). The influencing factors of clinical pregnancy rate were identified by binary Logistic regression analysis. Advanced age was found to be a risk factor for improving the pregnancy rate, while the increase in the number of oocytes retrieved is a protective factor for improving the pregnancy rate. The differences were statistically significant (0.05).

CONCLUSION

The antagonist regimen has a low dosage and short medication time and can achieve a high embryo utilization rate and blastula formation rate, saving time and cost for patients.

摘要

目的

比较接受长卵泡期方案和拮抗剂方案治疗的患者进行新鲜周期或冻融周期胚胎移植的妊娠结局,探讨两种方案的临床治疗效果。

方法

本研究为回顾性研究。回顾性分析了2020年1月至2022年12月在保定市妇幼保健院接受体外受精/卵胞浆内单精子注射及胚胎移植(IVF/ICSI-ET)或冻融胚胎移植(FET)的543例患者的数据,并将其分为四组,分析每组患者胚胎移植后的基本情况、用药情况、实验室指标及临床结局。

结果

A、B、C组的妊娠率和着床率均高于D组,差异有统计学意义(P<0.05)。各组间多胎妊娠率和流产率的差异无统计学意义(P>0.05)。采用二元Logistic回归分析确定临床妊娠率的影响因素。发现高龄是降低妊娠率的危险因素,而获卵数增加是提高妊娠率的保护因素。差异有统计学意义(P<0.05)。

结论

拮抗剂方案用药剂量低、用药时间短,可实现较高的胚胎利用率和囊胚形成率,为患者节省时间和费用。

相似文献

1
Comparison of efficacy of long follicular phase regimen and antagonist regimen on pregnancy outcome of fresh cycle or freeze-thawed cycle embryo transfer.长卵泡期方案与拮抗剂方案对新鲜周期或冻融周期胚胎移植妊娠结局的疗效比较。
Pak J Med Sci. 2024 Nov;40(10):2170-2175. doi: 10.12669/pjms.40.10.9050.
2
Cumulative live birth rates after one ART cycle including all subsequent frozen-thaw cycles in 1050 women: secondary outcome of an RCT comparing GnRH-antagonist and GnRH-agonist protocols.1050名女性在一个辅助生殖技术周期(包括所有后续冻融周期)后的累积活产率:一项比较促性腺激素释放激素拮抗剂和促性腺激素释放激素激动剂方案的随机对照试验的次要结果。
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[Effects of time of recombinant luteinized hormone supplementation on pregnancy outcomes of women with advanced reproductive age during follicular-phase long protocol].[重组促黄体生成素补充时间对卵泡期长方案中高龄女性妊娠结局的影响]
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Analysis of IVF/ICSI-FET Outcomes in Women With Advanced Endometriosis: Influence on Ovarian Response and Oocyte Competence.分析患有中重度子宫内膜异位症的妇女行 IVF/ICSI-FET 的结局:对卵巢反应和卵母细胞质量的影响。
Front Endocrinol (Lausanne). 2020 Jul 17;11:427. doi: 10.3389/fendo.2020.00427. eCollection 2020.
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[Clinical effects of oocyte cryopreservation in assisted reproduction technology].[卵母细胞冷冻保存技术在辅助生殖中的临床效果]
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[Impact of BMI on fresh cycle embryo transfer outcome of IVF/ICSI in patients with early follicular phase prolonged protocol].[BMI对卵泡早期延长方案患者IVF/ICSI新鲜周期胚胎移植结局的影响]
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引用本文的文献

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Effects of different embryonic development days on clinical outcomes of freeze-thawed embryo transfer.不同胚胎发育天数对冻融胚胎移植临床结局的影响。
Pak J Med Sci. 2025 Apr;41(4):1087-1091. doi: 10.12669/pjms.41.4.9634.

本文引用的文献

1
Correlation of Blastocyst Quality and Pregnancy Outcome during Freeze - Thaw Cycle.冻融周期中囊胚质量与妊娠结局的相关性
J Coll Physicians Surg Pak. 2021 Mar;31(3):278-281. doi: 10.29271/jcpsp.2021.03.278.
2
Comparisons of GnRH antagonist versus GnRH agonist protocol in supposed normal ovarian responders undergoing IVF: a systematic review and meta-analysis.体外受精中假定正常卵巢反应者使用促性腺激素释放激素拮抗剂与促性腺激素释放激素激动剂方案的比较:一项系统评价和荟萃分析。
PLoS One. 2014 Sep 12;9(9):e106854. doi: 10.1371/journal.pone.0106854. eCollection 2014.
3
GnRH agonist and GnRH antagonist protocols: comparison of outcomes among good-prognosis patients using national surveillance data.促性腺激素释放激素激动剂和促性腺激素释放激素拮抗剂方案:利用国家监测数据对预后良好患者的结局进行比较。
Reprod Biomed Online. 2014 Sep;29(3):299-304. doi: 10.1016/j.rbmo.2014.05.007. Epub 2014 Jun 12.
4
Premature formation of nucleolar channel systems indicates advanced endometrial maturation following controlled ovarian hyperstimulation.核仁通道系统过早形成表明控制性卵巢超刺激后子宫内膜成熟度提高。
Hum Reprod. 2013 Dec;28(12):3292-300. doi: 10.1093/humrep/det358. Epub 2013 Sep 18.
5
Comparison of the GnRH agonist and antagonist protocol on the same patients in assisted reproduction during controlled ovarian stimulation cycles.在控制性卵巢刺激周期的辅助生殖过程中,对同一批患者使用促性腺激素释放激素激动剂方案和拮抗剂方案的比较。
Int J Clin Exp Pathol. 2013 Aug 15;6(9):1903-10. eCollection 2013.
6
The type of GnRH analogue used during controlled ovarian stimulation influences early embryo developmental kinetics: a time-lapse study.在控制性卵巢刺激过程中使用的 GnRH 类似物会影响早期胚胎发育动力学:一项时间延迟研究。
Eur J Obstet Gynecol Reprod Biol. 2013 Jun;168(2):167-72. doi: 10.1016/j.ejogrb.2012.12.038. Epub 2013 Jan 22.
7
MILD ovarian stimulation with GnRH-antagonist vs. long protocol with low dose FSH for non-PCO high responders undergoing IVF: a prospective, randomized study including thawing cycles.拮抗剂方案与小剂量促性腺激素长方案用于非 PCOS 高反应患者 IVF 中:一项包括解冻周期的前瞻性、随机研究。
J Assist Reprod Genet. 2012 Dec;29(12):1343-51. doi: 10.1007/s10815-012-9863-2. Epub 2012 Oct 20.
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The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting.《伊斯坦布尔胚胎评估共识工作坊:专家会议记录》。
Hum Reprod. 2011 Jun;26(6):1270-83. doi: 10.1093/humrep/der037. Epub 2011 Apr 18.
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Integrins and ion channels in cell migration: implications for neuronal development, wound healing and metastatic spread.整合素与离子通道在细胞迁移中的作用:对神经元发育、创伤愈合和转移扩散的启示。
Adv Exp Med Biol. 2010;674:107-23. doi: 10.1007/978-1-4419-6066-5_10.
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Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer.囊胚评分影响着床和妊娠结局:迈向单囊胚移植。
Fertil Steril. 2000 Jun;73(6):1155-8. doi: 10.1016/s0015-0282(00)00518-5.