Effect of combination of letrozole and antagonist regimens on outcome of ovulation induction in patients with unanticipated low prognosis under Poseidon standard
Objective To explore the effect of adding letrozole to an antagonist regimen on the outcome of ovulation in-duction in a population meeting the classification criteria of Poseidon for"unexpected low prognosis".Methods This study retrospectively analyzed the in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)data of patients who visited the Reproductive Center of Henan Provincial People's Hospital from January 2017 to December 2019 and met the Poseidon classification criteria for unexpected low prognosis for a total of 188 cycles.The patients were divided into ob-servation group(n=74)treated with antagonist regimen combined with letrozole and control group(n=114)not treated with letrozole according to the presence or absence of letrozole in the antagonist regimen.The general data,ovulation in-duction outcomes and pregnancy outcomes were compared between the two groups.Results No significant difference was observed in the basic data between the two groups(P＞0.05);Gn consumption in the observation group was significant-ly lower than that of the control group[(1 896.40±701.47)vs(2 032.98±760.73),P＜0.05];the mean number of oocytes retrieved[(9.27±4.32)vs(6.97±3.90),P＜0.05],number of metaphase II(MII)[(7.56±3.82)vs(6.02±3.32),P＜0.05],and high-quality embryo rate(28.89％ vs 20.75％,P＜0.05)in the observation group were significantly higher than those of the control group;there were no significant differences in the incidence of moderate to severe ovarian hyperstimulation syndrome,the number of 2 pronuclear,the number of D3 available embryos,the can-cellation rate of cycles without transferable embryos,the clinical pregnancy rate,the early abortion rate,and the live birth rate between the two groups(P＞0.05).Conclusion Letrozole combined with antagonist regimen in patients with unexpected low prognosis of Poseidon criteria can increase the average number of oocytes retrieved and MII eggs,in-crease the rate of high-quality embryos,and reduce the dosage of Gn,but it may adversely affect pregnancy outcomes in fresh transplant cycles.
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