Berkovitz-Shperling Roza, Libai Yaara, Aviv Shir, Dalit Ben-Yosef, Foad Azem, Ido Feferkorn
Department of Obstetrics and Gynecology, Lis Hospital for Women's Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel, affiliated to the Faculty of Medicine, Tel Aviv University, 6 Weizman St., 6423906, Tel Aviv, Israel.
J Assist Reprod Genet. 2025 May 9. doi: 10.1007/s10815-025-03503-8.
Does the use of GnRH agonist trigger versus hCG trigger affect the length of the subsequent follicular phase in women?
A retrospective cohort study analyzing 196 women undergoing controlled ovarian stimulation with freeze-all for PGT-M at a university-affiliated fertility center; 132 received GnRH agonist trigger, and 64 received hCG trigger.
The GnRH agonist group demonstrated a significantly longer subsequent follicular phase compared to the hCG group (18.98 ± 3.54 vs. 16.06 ± 3.13 days, P < .001), with extended follicular phase occurring in 90.2% versus 60.9% of cycles (P < .001). Both groups had comparable antral follicle counts (14.52 ± 7.71 vs. 13.00 ± 15.36, P = .748). Multiple regression analysis identified GnRH agonist trigger as a significant independent predictor of subsequent follicular phase length (coefficient = 4.552, 95% CI: 3.058-6.045, P < .001), along with BMI (coefficient = 0.188, 95% CI: 0.019-0.357, P = .030). The model explained 31.4% of the variance in follicular phase length (F = 7.516, P < .001). After adjusting for confounding variables, pregnancy rates were comparable between groups (OR = 1.763, 95% CI: 0.798-3.505, P = .173).
The GnRH agonist trigger prolongs the subsequent follicular phase compared to the hCG trigger without compromising pregnancy rates. BMI showed a statistically significant but modest association with follicular phase length that requires further validation. These findings have important implications for optimizing the timing of frozen embryo transfer in subsequent cycles and may facilitate more personalized monitoring protocols.
与使用人绒毛膜促性腺激素（hCG）扳机相比，使用促性腺激素释放激素（GnRH）激动剂扳机是否会影响女性后续卵泡期的时长？
一项回顾性队列研究，分析了在一家大学附属医院生殖中心接受用于植入前基因检测-单基因病（PGT-M）的全胚冷冻控制性卵巢刺激的196名女性；132名接受GnRH激动剂扳机，64名接受hCG扳机。
与hCG组相比，GnRH激动剂组的后续卵泡期明显更长（18.98±3.54天对16.06±3.13天，P<0.001），卵泡期延长的周期在GnRH激动剂组和hCG组中分别为90.2%和60.9%（P<0.001）。两组的窦卵泡计数相当（14.52±7.71对13.00±15.36，P=0.748）。多元回归分析确定GnRH激动剂扳机是后续卵泡期时长的显著独立预测因素（系数=4.552，95%置信区间：3.058-6.045，P<0.001），同时还有体重指数（BMI）（系数=0.188，95%置信区间：0.019-0.357，P=0.030）。该模型解释了卵泡期时长31.4%的方差（F=7.516，P<0.001）。在对混杂变量进行调整后，两组的妊娠率相当（比值比=1.763，95%置信区间：0.798-3.505，P=0.173）。
与hCG扳机相比，GnRH激动剂扳机可延长后续卵泡期，且不影响妊娠率。BMI与卵泡期时长显示出具有统计学意义但程度适中的关联，这需要进一步验证。这些发现对于优化后续周期中冷冻胚胎移植的时机具有重要意义，并且可能有助于制定更个性化的监测方案。
