Comparison of the efficacy of depot GnRH agonist protocol and the GnRH antagonist protocol in patients with repeated IVF failure: a retrospective cohort study.

IF 2.1 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Human Fertility Pub Date : 2023-12-01 Epub Date: 2023-03-22 DOI:10.1080/14647273.2023.2175267
Tingting Li, Xiaoping Liu, Xing Yang, Ningning Wang, Yanfang Wang, Wei Li, Xiaoyan Liang, Rui Huang
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Abstract

The aims of the research were (i) to compare the clinical outcome of IVF using follicular-phase depot gonadotropin-releasing hormone (GnRH) agonist (depot agonist) protocol and GnRH antagonist protocol in patients with repeated IVF failure (RIF), (ii) to discover the optimal ovarian stimulation protocol for this group of low prognosis patients. 801 RIF patients with normal ovarian reserve receiving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) were included in this retrospective study. Among them, 492 patients were treated with the depot agonist protocol, and the remaining 309 patients with the antagonist protocol. Multivariable logistic regression analysis was used to find the predictor(s) of the chance of live birth. Higher live birth rate (LBR) and clinical pregnancy rate (CPR) in fresh embryo transfer (ET) cycles were associated with the use of depot agonist compared with the antagonist protocols (44.81% vs. 27.27%, 54.64% vs. 34.93%, respectively; both p < 0.01) and depot agonist protocol was a strong predictor of live birth (OR = 2.182, 95% CI 1.355-3.514, p < 0.01). The CPR in thawed ET cycles was not significantly different between the two groups (38.12% vs. 45.26%, p > 0.05). A higher cumulative live birth rate (CLBR) was achieved in the depot agonist group (46.59% vs. 35.21%, p < 0.01). Beneficial endometrial receptivity in the depot agonist protocol contributed to a higher LBR in fresh ET cycles, rendering this protocol the preferred option in the treatment of RIF patients.

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反复试管婴儿失败患者使用去势 GnRH 激动剂方案和 GnRH 拮抗剂方案的疗效比较:一项回顾性队列研究。
这项研究的目的是:(i) 比较反复试管婴儿失败(RIF)患者使用卵泡期去卵泡促性腺激素释放激素(GnRH)激动剂(去势激动剂)方案和GnRH拮抗剂方案进行试管婴儿的临床结果;(ii) 探索适用于这类低预后患者的最佳卵巢刺激方案。这项回顾性研究共纳入了 801 名卵巢储备正常、接受体外受精/卵胞浆内单精子显微注射(IVF/ICSI)的 RIF 患者。其中,492 名患者接受了去势激动剂方案治疗,其余 309 名患者接受了拮抗剂方案治疗。研究采用了多变量逻辑回归分析来寻找预测活产几率的因素。与拮抗剂方案相比,在新鲜胚胎移植(ET)周期中,使用去势激动剂方案的活产率(LBR)和临床妊娠率(CPR)更高(分别为44.81%对27.27%,54.64%对34.93%;两者的P P > 0.05)。去势激动剂组的累积活产率(CLBR)较高(46.59% 对 35.21%,p
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来源期刊
Human Fertility
Human Fertility OBSTETRICS & GYNECOLOGY-REPRODUCTIVE BIOLOGY
CiteScore
3.30
自引率
5.30%
发文量
50
期刊介绍: Human Fertility is a leading international, multidisciplinary journal dedicated to furthering research and promoting good practice in the areas of human fertility and infertility. Topics included span the range from molecular medicine to healthcare delivery, and contributions are welcomed from professionals and academics from the spectrum of disciplines concerned with human fertility. It is published on behalf of the British Fertility Society. The journal also provides a forum for the publication of peer-reviewed articles arising out of the activities of the Association of Biomedical Andrologists, the Association of Clinical Embryologists, the Association of Irish Clinical Embryologists, the British Andrology Society, the British Infertility Counselling Association, the Irish Fertility Society and the Royal College of Nursing Fertility Nurses Group. All submissions are welcome. Articles considered include original papers, reviews, policy statements, commentaries, debates, correspondence, and reports of sessions at meetings. The journal also publishes refereed abstracts from the meetings of the constituent organizations.
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