激动剂长方案下促性腺激素使用时长对体外受精胚胎移植妊娠结局的影响

目的 探讨控制性超促排卵(COH)周期中,促性腺激素(Gn)的使用天数对卵巢反应良好者的获卵数量、胚胎发育情况以及妊娠结局的影响,并探讨导致Gn使用时间延长的可能影响因素.方法 将3054例行体外受精-胚胎移植(IVF-ET)助孕患者按照Gn刺激时长分成A、B、C 3组(A组:Gn天数≤7 d;B组:8 d≤Gn天数≤...

Effect of Gn stimulation duration on pregnancy outcome of IVF-ET in long GnRHa protocol

Objective To investigate the effect of the duration of gonadotropin(Gn)in the controlled ovarian hyper stimulation(COH)cycle on the number of eggs obtained, embryo development, and pregnancy outcome in those with good ovarian response, and to analyze the possible factors that contributed to the prolongation of Gn use. Methods A total of 3 054 patients undergoing in vitro fertilization-embryo transfer(IVF-ET)were divided into groups A, B, and C according to the days of Gn use(group A: Gn days≤7 d; group B: 8 d ≤Gn days ≤11 d; group C: Gn days ≥12 d).The baseline data, COH and pregnancy outcomes were compared. The possible factors leading to the prolongation of Gn use were analyzed with Logistics regression. Results The highest BMI and FSH levels were found in group C(P=0.001), while the lowest AMH and AFC levels were found in group C(P=0.022, 0.002). The Gn starting dose, total Gn dose and downregulation days in group A were the least among the three groups(P<0.001). There were no significant differences among the three groups in indicators related to COH treatment and pregnancy outcomes(P=0.86, 0.57, 0.91, 0.64). Logistics regression showed that higher BMI and Gn starting dose were risk factors of prolonged Gn use, while higher AMH and AFC, lower FSH level and shorter downregulation days were protective factors of prolonged Gn use. Conclusion The duration of Gn use has no significant effect on the pregnancy outcomes of IVF-ET. Higher BMI and Gn starting dose can significantly prolong Gn use, while higher AMH and AFC, lower FSH level and shorter downregulation days can significantly shorten Gn use.