Tian Ying, Hao Jing, Tu Xueliang, Feng Shaobin, Li Mingtao, Chen Yang, Cao Zelei
Department of Reproductive Medicine, Yellow River Sanmenxia Affiliated Hospital of Henan University of Science and Technology, Sanmenxia, China.
Front Endocrinol (Lausanne). 2025 Aug 8;16:1526895. doi: 10.3389/fendo.2025.1526895. eCollection 2025.
Ovarian stimulation protocols play a pivotal role in the success of fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments. This study compares the clinical outcomes of the long luteal phase GnRH agonist protocol and the flexible GnRH antagonist protocol in patients with normal ovarian reserve.
This prospective cohort study was conducted at the Reproductive Medicine Center, Sanmenxia Hospital, Yellow River, from March 2021 to September 2023. Patients with normal ovarian reserve were enrolled and randomly assigned by a 1:3 ratio to either the long luteal phase protocol (Group A, n=42) or the flexible antagonist protocol (Group B, n=118). Data on patient characteristics, ovarian response, and embryological outcomes were collected and analyzed. Clinical outcomes, including clinical pregnancy, live birth rates, and ovarian hyperstimulation syndrome (OHSS) incidence, were assessed. Multivariate logistic regression was conducted to identify risk factors associated with clinical pregnancy.
There were no significant differences in baseline characteristics between the two groups (>0.05). In terms of primary clinical outcomes, there were no significant differences in clinical pregnancy rate (54.8% . 56.8%, =0.092), live birth rate (47.6% . 52.5%, =0.278), or incidence of OHSS (0% . 2.5%, =0.055) between Group A and Group B. Multivariable logistic regression analysis identified significant predictors of clinical pregnancy, including younger age (OR = 0.956, = 0.042), higher AFC (OR = 1.127, = 0.018), higher AMH levels (OR = 1.357, = 0.005), greater endometrial thickness (OR = 1.162, = 0.021), higher number of oocytes retrieved (OR = 1.234, = 0.023), and better embryo quality (Grade I-II) (OR = 1.485, = 0.002). No significant differences were observed between age-related subgroups (>0.05), but success rates decreased with increasing age, highlighting age as a key factor influencing IVF/ICSI outcomes.
The study found no significant differences in primary clinical outcomes between the two groups. However, younger age, higher AFC, higher AMH levels, greater endometrial thickness, higher number of oocytes retrieved, and better embryo quality were significant predictors of clinical pregnancy.
卵巢刺激方案在体外受精（IVF）和卵胞浆内单精子注射（ICSI）治疗的成功中起着关键作用。本研究比较了正常卵巢储备患者中长效黄体期促性腺激素释放激素（GnRH）激动剂方案和灵活GnRH拮抗剂方案的临床结局。
本前瞻性队列研究于2021年3月至2023年9月在黄河三门峡医院生殖医学中心进行。纳入正常卵巢储备的患者，并按1:3的比例随机分配至长效黄体期方案组（A组，n = 42）或灵活拮抗剂方案组（B组，n = 118）。收集并分析患者特征、卵巢反应和胚胎学结局的数据。评估临床结局，包括临床妊娠、活产率和卵巢过度刺激综合征（OHSS）发生率。进行多因素逻辑回归分析以确定与临床妊娠相关的危险因素。
两组间基线特征无显著差异（>0.05）。在主要临床结局方面，A组和B组在临床妊娠率（54.8%对56.8%，P = 0.092）、活产率（47.6%对52.5%，P = 0.278）或OHSS发生率（0%对2.5%，P = 0.055）方面均无显著差异。多因素逻辑回归分析确定了临床妊娠的显著预测因素，包括年龄较小（OR = 0.956，P = 0.042）、较高的窦卵泡计数（AFC）（OR = 1.127，P = 0.018）、较高的抗缪勒管激素（AMH）水平（OR = 1.357，P = 0.005）、较厚的子宫内膜厚度（OR = 1.162，P = 0.021）、较高的获卵数（OR = 1.234，P = 0.023）和较好的胚胎质量（I-II级）（OR = 1.485，P = 0.002）。在年龄相关亚组间未观察到显著差异（>0.05），但成功率随年龄增加而降低，突出了年龄是影响IVF/ICSI结局的关键因素。
该研究发现两组间主要临床结局无显著差异。然而，年龄较小、较高的AFC、较高的AMH水平、较厚的子宫内膜厚度、较高的获卵数和较好的胚胎质量是临床妊娠的显著预测因素。
