| Abstract: | Objective To compare the assisted-reproduction outcomes of two long-acting gonadotropin-releasing hormone agonists(GnRH-a)in patients undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)during the long-term early follicular phase.Methods A retrospective cohort study was conducted in the Reproductive Center of the Second Affiliated Hospital of Wenzhou Medical University from March 1,2019 to July 31,2019.A total of 802 patients were divided into leuprorelin acetate group(group A)and triptorelin group(group B)according to the difference of long-acting GnRH-a in the long-term early follicular phase,and the clinical and laboratory outcomes between the two groups were compared.Results There were no significant differences in age,infertility duration,body mass index(BMI),basic hormone levels,infertility type,sex hormone level on the day of initiation of injection of gonadotropin(Gn),total duration and dosage of Gn used,duration of down-regulation,estradiol level and endometrial thickness on hCG injection day,the number of embryos transferred,clinical outcomes,total treatment cost,and owing to the uneven inner membrane,elevated progesterone,embryo quality problems,individual factors resulting in cancelling the transplant,between the two groups(P>0.05).However,antral follicle count(AFC)(19.59±7.93),the number of retrieved oocytes(15.39±7.59),fertilized oocytes(11.20±6.53),cleaved oocytes(10.85±6.42),good-quality embryos on Day 3(3.01±2.66),and blastocysts(5.27±4.02)in group B was larger than that in group A(17.68±7.23,13.70±6.94,9.50±5.43,9.26±5.34,2.57±2.33,4.49±3.40)(P=0.001,P=0.002,P<0.001,P=0.001,P=0.017,P=0.007).The levels of luteinizing hormone(LH)(0.78±0.64)IU/L]and progesterone(0.72±0.39)μg/L]on hCG injection day in group A were higher than those in group B(0.55±0.30)IU/L,(0.64±0.36)μg/L](P<0.001,P=0.005).The rate of preventing the occurrence of ovarian hyperstimulation syndrome(OHSS)in group A28.52%(75/263)]was higher than that in group B14.95%(16/107),P=0.006].Conclusion Two long-acting GnRH-a drugs can achieve satisfactory down-regulation effect,laboratory and clinical outcomes in the long-term early follicular phase.Compared with the triptorelin,leuprolide acetate is relatively mild to pituitary inhibition,with an increasing trend of the clinical pregnancy rate. |
