Effects of hormone changes 12 h after hCG trigger on the outcomes of IVF/ICSI-ET treatment with GnRH-a protocol
Objective To explore the effects of human chorionic gonadotropin(hCG),progesterone as well as the change of estradiol 12 h after hCG trigger on the outcomes of in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET).Methods A retrospective study was conducted at the Center for Reproduction and Genetics of the Affiliated Suzhou Hospital of Nanjing Medical University.A total of 2 506 patients received IVF/ICSI-ET treatment with gonadotropin-releasing hormone agonist(GnRH-a)protocol from March 2015 to June 2020 were selected.With Spearman rank correlation analysis and path analysis,we explore the relationship among the changes of these hormones and the baseline characteristic of patients,as well as the relationship among the changes of these hormones and the outcomes of IVF treatment.Results The increase of hCG was accompanied by the rise of progesterone and the decline of estradiol change rate(r=0.094,P＜0.001;r=-0.093,P＜0.001).Meanwhile the rise of progesterone was accompanied by the decline of estradiol change rate(r=-0.089,P＜0.001).The dosage of hCG trigger was directly positively correlated to hCG level after hCG trigger,path coefficients(PC)was 0.307(P＜0.001).Body mass index(BMI)was directly negatively correlated to hCG level and progesterone level after hCG trigger(PC=-0.434,P＜0.001;PC=-0.154,P＜0.001),whereas positively correlated to estradiol change rate(PC=0.097,P＜0.001).Meanwhile the duration and dosage of gonadotropin(Gn)used were positively correlated to progesterone level after hCG trigger(PC=0.102,P＜0.001;PC=0.080,P=0.030).hCG level and progesterone level after hCG trigger had positive correlation to oocyte retrieved rate(PC=0.098,P＜0.001;PC=0.080,P＜0.001).While estradiol change rate was not correlated to oocyte retrieved rate(P＞0.05).Progesterone level on hCG trigger day negatively related to normal fertilization rate(PC=-0.050,P=0.039).hCG level,progesterone level and estradiol change rate after hCG trigger had no correlation with high-quality embryo rate,clinical pregnancy rate and live birth rate(all P＞0.05).Conclusion Oocyte retrieved rate was positively affected by hCG level and progesterone level 12 h after hCG trigger.While normal fertilization rate,high-quality embryo rate,clinical pregnancy rate and live birth rate were not affected by the change of hormones level 12 h after hCG trigger.Therefore we should pay attention to hCG level and progesterone level 12 h after hCG trigger.
Human chorionic hormoneProgesteroneEstradiol change rateOocyte retrieved rateFertilization rate
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