Analysis of influencing factors of pregnancy outcomes in fresh embryo transfer cycle with GnRH antagonist protocol
Objective:To explore the influencing factors of pregnancy outcomes in fresh embryo transfer cycle with GnRH antagonist protocol.Methods:A retrospective study was conducted on clinical data of patients who underwent IVF/ICSI-ET in Characteristic Medical Center of Chinese People's Armed Police Force from June 2020 to June 202 3.According to the inclusion and exclusion criteria,a total of 713 cycles were included.According to whether clinically pregnant or not,the patients were divided into two groups as the pregnant group(n=3 64)and the non-pregnant group(n=3 4 9).The basic characteristics,ovulation induction and embryo development as well as factors influencing pregnancy outcomes were compared between two groups.Results:The overall clinical pregnancy rate of 713 cycles included in this study was 51.1％(364/713),with a live birth rate of 41.4％(295/713)and an incidence rate of OHSS of 0.7％(5/713).There were no significant difference in basic characteristics between the two groups(P＞0.05).There were no significant differences in terms of gonadotropin(Gn)initiation dose,total amount of Gn use,total amount of antagonist use,endometrial thickness on the trigger day and the number of retrieved and MⅡ oocytes between the two groups(P＞0.05).The utilization rate of FSH for Gn initiation(83.2％vs.76.2％)and type A endometrium rate on the trigger day(87.4％vs.76.2％)in the pregnancy group were significantly higher than those in the non-pregnancy group(P＜0.05).The estradiol(E2)level on the Gn initiation day in the pregnant group was significantly lower than that in the non-pregnant group[(135.4±62.2)pmol/L vs.(146.4±69.5)pmol/L,P＜0.05].The number of pronuclear[2PNs,(6.2±3.4)vs.(5.6±4.0)],available embryos[(5.0±2.4)vs.(4.2±2.8)],high-quality embryos[(2.9±2.1)vs.(2.4±2.3)]and transferred embryos[(l.8±0.3)vs.(1.7±0.4)]in the pregnant group was significantly higher than that in the non-pregnant group(P＜0.05).Multivariate logistic regression analysis showed that E2 level on the initiation day,the endometrial type on the trigger day,the number of available embryos and the number of transferred embryos were independent factors of pregnancy outcomes(P＜0.05).Conclusions:When patients were treated with GnRH antagonist protocols,the lower estrogen level on the initiation day and the higher number of type A endometria on the trigger day,available embryos and transferred embryos were related with higher clinical pregnancy rate after fresh cycle transplantation.
万方数据
维普
