Effect of sequential transfer combined with GnRH-a on pregnancy outcome for patients with unexplained repeated implantation failure in frozen embryo cycles
Objective To explore the effect of sequential transfer combined with gonadotropin releasing hormone-agonist(GnRH-a)on pregnancy outcome for patients with unexplained repeated implantation failure(RIF)in frozen embryo cycles.Methods A retrospective analysis was performed on 314 patients who were admitted to Hangzhou Women's Hospital from January 2017 to January 2023 underwent hormone replacement cycle frozen embryo transfer and diagnosed as unexplained RIF.According to the status of embryo transfer and whether GnRH-a was used,the patients were divided into 2 early embryo groups(2D3 group),2 blastocyst groups(2D5/6 group),sequential transfer group(sequential group),and sequential transfer combined with GnRH-a group(sequential+GnRH-a group).The parameters of frozen embryo transfer cycle and pregnancy outcome of the 4 groups were compared,and the influencing factors of clinical pregnancy in patients with unexplained RIF were analyzed by univariate and multivariate logistic regression.Results There was no significant difference in frozen embryo transfer parameters,such as estradiol,progesterone,thickness of the endometrium,number of embryos transferred and source of blastocyst among the 4 groups(all P＞0.05),except for the difference in hormone replacement regimen(P=0.037).The clinical pregnancy rate in sequential+GnRH-a group was significantly higher than those in other groups(all P＜0.025),and that in sequential group was higher than that in 2D3 group(P＜0.025).The implantation rate and live birth rate of sequential+GnRH-a group were higher than those of sequential group and 2D3 group(all P＜0.025),and those of sequential group were higher than those of 2D3 group(all P＜0.025).The multiple pregnancy rate in the sequential+GnRH-a group was lower than that in the 2D6/6 group but higher than that in the 2D3 group(both P＜0.025),and that in sequential group was lower than that in 2D5/6 group(P＜0.025).There was no significant difference in the early abortion rate among the 4 groups(P=0.921).Compared with sequential,2D5/6,2D3,sequential+GnRH-a was an independent protective factor for clinical pregnancy in patients with unexplained RIF(OR=0.659,0.585,0.315,all P＜0.05).Conclusion Sequential transfer combined with GnRH-a can improve the pregnancy outcome of frozen embryo cycle in patients with unexplained RIF.
万方数据
维普
