Effect of different ovarian stimulation protocols on the cumulative live birth rates of endometriosis patients with diminished ovarian reserve
Objective:To compare the cumulative live birth rates of patients with diminished ovarian reserve(DOR)and endometriosis(EMS)between GnRH antagonist regimen and GnRH agonist regimen.Methods:The clinical data of 218 ovarian EMS patients with DOR undergoing IVF/ICSI-ET in Reproductive Center,Department of Obstetric and Gynecology,the 980th Hospital of PLA Joint Logistics Support Forces from June 2022 to June 2023 were retrospectively analyzed.A total of 218 oocyte retrieval cycles were included.The patients were divided into two groups as ≤35 years old group(139 cycles)and＞35 years old group(79 cycles).Then each group was further divided into subgroups as the antagonist group and GnRH-a group based on controlled ovarian hyperstimulation(COH)regimen.The demographic characteristics,COH duration,laboratory indicators related to embryo,and pregnancy outcomes were compared among these groups.Results:There were no significant differences in infertility years,body mass index(BMI),basic sex hormone levels and infertility types between two subgroups of both ≤35 years old group and＞35 years old group(P＞0.05).The duration and dosage of gonadotropin(Gn)use in the antagonist regimen were significantly lower(P＜0.05)and the level of luteinizing hormone on HCG day was significantly higher than those in the GnRH-a group(P＜0.05).In ≤35 years old group,the number of oocytes retrieved and MⅡ oocytes in the antagonist group was significantly lower than that in GnRH-a group(P＜0.05),and the number of high-quality embryos and frozen embryos,the available embryo and high-quality embryo rates were significantly higher than that in GnRH-a group(P＜0.05).In＞35 years old group,the number of oocytes retrieved and M Ⅱ oocytes in the antagonist group was significantly lower than that in GnRH-a group(P＜0.05),and the number of frozen embryos,the rates of available embryos and high-quality embryos were significantly higher than those in GnRH-a group(P＜0.05).In ≤35 years old group,the pregnancy rate of fresh transplantation in the antagonist group was significantly higher than that in the GnRH-a group(P＜0.05).There were no significant differences in live birth rate with fresh embryo transfer,cumulative live birth rate of the cycle with a single oocyte retrieval and cumulative miscarriage rate between two subgroups of both ≤35 years old group and＞35 years old group(P＞0.05).Conclusions:For ovarian EMS infertility patients with DOR aged not more than 35 years,antagonist regimen and long regimen have both advantages and disadvantages.It suggests for the clinicians that the appropriate ovulation induction regimen is chosen according to the specific conditions of patients.For ovarian EMS infertility patients with DOR aged less than 35 years,the antagonist regimen has the similar cumulative live birth rate with the long-term regimen,but a higher miscarriage rate should be paid attention to,so ART may be recommended as early as possible.
EndometriosisDiminished ovarian reserveGnRH antagonist regimenCumulative live birth rate
万方数据
维普
