Xiao Shan, Liu Su, Hong Ling, Liu Zhiqiang, Jia Rui, Zhang Hongzhan, Mo Meilan, Yang TuRui
Shenzhen Key Laboratory of Reproductive Immunology for Peri-implantation, Shenzhen Zhongshan Institute for Reproductive Medicine and Genetics, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, 518000, Guangdong, People's Republic of China.
Guangdong Engineering Technology Research Center of Reproductive Immunology for Peri-implantation, Shenzhen, 518000, Guangdong, People's Republic of China.
Sci Rep. 2025 Jul 1;15(1):21002. doi: 10.1038/s41598-025-06217-0.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder with dysfunctional ovulation affecting female fertility. The purpose of this study was to determine the association between gonadotropin (Gn) duration and in vitro fertilization (IVF) outcomes in PCOS women undergoing GnRH antagonist treatment. Retrospective cohort study at a large private fertility practice. Patients with PCOS undergoing the GnRHantagonist treatment between January 1, 2017, and July 31, 2021 were included. Patients were classified into two groups depending on their Gn duration, ≤ 8 days (n = 501) and >8 days (n = 1326). After propensity score matching (PSM), there were 87 PCOS women with Gn duration ≤ 8 days and 137 PCOS women with Gn duration >8 days in the fresh embryo transfer cycle. The primary outcomes measures included the clinical pregnancy, ongoing pregnancy, early miscarriage and live birth rate between the two groups after fresh embryo transfer. In addition, the embryo quality was also evaluated. There was no significant difference in baseline characteristics between groups. However, the total Gn dosage was lower in PCOS women in the ≤ 8 days group. In addition, the oocytes retrieved and D3 high quality embryos were compared between groups. However, the number of 2PN embryos was decreased in the group with Gn duration ≤ 8 days. The clinical pregnancy and live birth rate were significantly decreased in the ≤ 8 days group in fresh embryo transfer (52.87% vs. % 68.61%, 43.68% vs. 59.12%). After logistic regression, PCOS women with Gn duration ≤ 8 days were associated with poor clinical pregnancy and live birth rate. PCOS women with shorter Gn duration (≤ 8 days) were not associated with impaired embryo outcomes except for 2PN embryos in GnRH antagonist protocol. However, the shorter Gn stimulation was detrimental to clinical pregnancy outcomes in fresh embryo transfer cycle.
多囊卵巢综合征（PCOS）是一种常见的内分泌紊乱疾病，排卵功能异常会影响女性生育能力。本研究的目的是确定接受GnRH拮抗剂治疗的PCOS女性中促性腺激素（Gn）使用时长与体外受精（IVF）结局之间的关联。在一家大型私立生育诊所进行回顾性队列研究。纳入2017年1月1日至2021年7月31日期间接受GnRH拮抗剂治疗的PCOS患者。根据Gn使用时长将患者分为两组，≤8天（n = 501）和>8天（n = 1326）。经过倾向得分匹配（PSM）后，在新鲜胚胎移植周期中，有87名Gn使用时长≤8天的PCOS女性和137名Gn使用时长>8天的PCOS女性。主要结局指标包括新鲜胚胎移植后两组之间的临床妊娠、持续妊娠、早期流产和活产率。此外，还评估了胚胎质量。两组之间的基线特征无显著差异。然而，≤8天组的PCOS女性总Gn剂量较低。此外，还比较了两组之间获取的卵母细胞和D3高质量胚胎。然而，Gn使用时长≤8天的组中2PN胚胎数量减少。新鲜胚胎移植中≤8天组的临床妊娠率和活产率显著降低（52.87%对68.61%，43.68%对59.12%）。经过逻辑回归分析，Gn使用时长≤8天的PCOS女性与临床妊娠和活产率低有关。在GnRH拮抗剂方案中，Gn使用时长较短（≤8天）的PCOS女性除2PN胚胎外，与胚胎结局受损无关。然而，较短的Gn刺激对新鲜胚胎移植周期中的临床妊娠结局不利。
