Shi Hongzhi, Zhao Zhi-Ming, Song Qi, Liu Jiajia
Hongzhi Shi, Department of Reproductive Medicine, Maternity & Child Care Center of Qinhuangdao, Qinhuangdao, 066000, Hebei, China.
Zhi-ming Zhao, Department of Reproductive Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050000, China.
Pak J Med Sci. 2025 Apr;41(4):986-991. doi: 10.12669/pjms.41.4.10188.
To explore factors influencing high-quality embryo rate in long protocols for controlled ovarian hyperstimulation (COH) during in vitro fertilization (IVF).
It was a retrospective case-control study including patients receiving assisted pregnancy treatment at the Reproductive Medicine Department of the Maternal & Child Care Center of Qinhuangdao from January 2018 to October 2023. This study adopted 724 treatment cycles using COH involving intermediate-acting and long-acting protocols. According to the high-quality embryo rate on D3, the enrolled patients were divided into Group-A for control (high-quality embryo rate ≥40%, n=297) and Group-B without high-quality embryo (excellent embryo rate=0, n=427). Factors with P<0.05 in the univariate analysis were incorporated into the Logistic regression model for binary logistic regression analysis.
There were no statistically significant differences in male age, years of infertility, body mass index (BMI), baseline follicle-stimulating hormone (FSH) levels, AMH, total gonadotropin (Gn)dose, total days of Gn administration, sperm concentration, motility, normal morphology rate, and LH levels on the day of human chorionic gonadotropin (hCG) injection between Group-A and Group-B (all p>0.05). In addition, the Logistic binary regression analysis showed that in the cycle without high-quality embryos on D3, elevated progesterone on the day of hCG injection was an independent risk factor affecting the developmental potential of late-stage embryos.
For cycles with poor embryo quality, the increase in progesterone levels in the late stage of COH has a significant negative impact on the formation of effective blastocysts.
探讨体外受精（IVF）过程中控制性卵巢刺激（COH）长方案中影响优质胚胎率的因素。
这是一项回顾性病例对照研究，纳入了2018年1月至2023年10月在秦皇岛市妇幼保健院生殖医学科接受辅助妊娠治疗的患者。本研究采用了724个使用COH的治疗周期，涉及中效和长效方案。根据第3天的优质胚胎率，将入选患者分为对照组A（优质胚胎率≥40%，n = 297）和无优质胚胎组B（优质胚胎率 = 0，n = 427）。单因素分析中P<0.05的因素纳入Logistic回归模型进行二元Logistic回归分析。
A组和B组在男性年龄、不孕年限、体重指数（BMI）、基础卵泡刺激素（FSH）水平、抗缪勒管激素（AMH）、总促性腺激素（Gn）剂量、Gn给药总天数、精子浓度、活力、正常形态率以及人绒毛膜促性腺激素（hCG）注射日的促黄体生成素（LH）水平方面，差异均无统计学意义（均p>0.05）。此外，Logistic二元回归分析显示，在第3天无优质胚胎的周期中，hCG注射日孕酮升高是影响晚期胚胎发育潜能的独立危险因素。
对于胚胎质量差的周期，COH后期孕酮水平升高对有效囊胚的形成有显著负面影响。
