Effects of trigger day endometrial thickness on pregnancy outcomes of fresh cycles in GnRH antagonist and agonist protocols
Aim:To investigate the effects of trigger day endometrial thickness(EMT)on pregnancy outcomes of fresh cycles in gonadotropin-releasing hormone antagonist(GnRH-ant)and agonist(GnRH-a)protocols.Methods:Patients who underwent in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)assisted reproduction at the Reproductive Medi-cine Center of the Second Affiliated Hospital of Zhengzhou University from January 2015 to December 2021 were selected.A total of 2 559 fresh embryo transfer cycles were selected,including 298 cycles of GnRH-ant protocol and 2 261 cycles of GnRH-a protocol.The patients were allocated into 3 groups according to the EMT on the trigger day:7～9 mm,>9～12 mm,and>12 mm groups.Clinical characteristics and pregnancy outcomes of the patients in the 3 groups accepting 2 proto-cols were compared.Results:For the patients accepting the GnRH-ant protocol,the clinical pregnancy rate,ongoing preg-nancy rate,and live birth rate in the EMT 7～9 mm group on the trigger day were lower than those in the other 2 groups(P<0.017).For the patients accepting GnRH-a protocol,the clinical pregnancy rate,ongoing pregnancy rate,and live birth rate in the EMT 7～9 mm group on the trigger day were lower than those in the EMT>9～12 mm group,and those in the EMT>9～12 mm group was lower than those in the EMT>12 mm group(P<0.017).Logistic regression analysis showed that patients with higher EMT on the trigger day had increased clinical pregnancy,ongoing pregnancy,and live birth[GnRH-ant protocol:OR(95%CI)for the EMT>9～12 mm group were 2.243(1.173-4.288),3.995(1.891-8.438),and 3.814(1.810-8.036),respectively,OR(95%CI)for the EMT>12 mm group were 3.298(1.490-7.299),6.637(2.742-16.065),and 5.249(2.184-12.616),respectively;GnRH-a protocol:OR(95%CI)for the EMT>9～12 mm group were 1.561(1.266-1.925),1.378(1.112-1.707),and 1.448(1.166-1.798),respectively,OR(95%CI)for the EMT>12 mm group were 2.266(1.747-2.940),2.257(1.736-2.933),and 2.254(1.732-2.933),respective-ly].Conclusion:Increasing EMT on the trigger day could improve pregnancy outcomes;whether in the GnRH-ant protocol or in the GnRH-a protocol,a higher EMT may be needed on the trigger day to achieve better pregnancy outcomes.
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