Liang Huanying, Zhao Jing, Chi Yan, Cai Jiangchuan, Li Guifeng, Zhang Yisheng, Liu Liling
Graduate School of Guangxi Medical University, Nanning, Guangxi Province, China.
Department of Reproductive Medicine and Genetics Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Province, China.
Medicine (Baltimore). 2025 Jun 27;104(26):e42965. doi: 10.1097/MD.0000000000042965.
This retrospective cohort study evaluates the clinical effects of an antagonist protocol on in vitro fertilization and intracytoplasmic sperm injection among infertile women with polycystic ovary syndrome. A propensity score matching analysis was conducted of 402 infertile women diagnosed with polycystic ovary syndrome undergoing in vitro fertilization/intracytoplasmic sperm injection cycles. The patients were divided into 2 groups: GnRH antagonist (GnRH-ant) pretreatment protocol (n = 202) and non-pretreatment protocol (n = 200). The primary outcome was the high-quality embryo rate. The metaphase II (MII) oocyte rate was calculated. After adjusting for confounders, the high-quality embryo rate (48.29% vs 42.74%, P = .010) was found to be significantly higher in the pretreatment group. However, the number of retrieved oocytes (12.00 vs 12.00, P = .878), the MII oocyte rate (76.6% vs 76.0%, P = .663), the incidence of ovarian hyperstimulation syndrome (6.82% vs 2.27%, P > .05), and the cycle cancelation rate (51.52% vs 51.52%, P > .05) were not significantly different between the 2 groups. Similar results were obtained in the propensity score matching analysis of live birth rate (LBR, 46.88% vs 40.63%, P = .476). GnRH-ant pretreatment protocol resulted in increased high-quality embryo rates without increasing the cycle cancelation rate and the incidence of ovarian hyperstimulation syndrome. The number of retrieved oocytes, the MII oocyte rate, and the clinical pregnancy outcomes did not differ after GnRH-ant pretreatment.
这项回顾性队列研究评估了拮抗剂方案对多囊卵巢综合征不孕女性体外受精和卵胞浆内单精子注射的临床效果。对402例诊断为多囊卵巢综合征并接受体外受精/卵胞浆内单精子注射周期治疗的不孕女性进行了倾向评分匹配分析。患者分为两组：促性腺激素释放激素拮抗剂（GnRH-ant）预处理方案组（n = 202）和非预处理方案组（n = 200）。主要结局是优质胚胎率。计算了中期II（MII）卵母细胞率。在调整混杂因素后，发现预处理组的优质胚胎率显著更高（48.29%对42.74%，P = .010）。然而，两组之间的获卵数（12.00对12.00，P = .878）、MII卵母细胞率（76.6%对76.0%，P = .663）、卵巢过度刺激综合征的发生率（6.82%对2.27%，P > .05）以及周期取消率（51.52%对51.52%，P > .05）无显著差异。在活产率（LBR）的倾向评分匹配分析中也得到了类似结果（46.88%对40.63%，P = .476）。GnRH-ant预处理方案可提高优质胚胎率，而不增加周期取消率和卵巢过度刺激综合征的发生率。GnRH-ant预处理后，获卵数、MII卵母细胞率和临床妊娠结局无差异。
