高孕激素促排卵在长方案移植失败患者行IVF/ICSI中的疗效

Abstract
Figure/Table
References (0)
Related Citation (2)

Download: PDF (1207 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To analyze the clinical outcomes of progestin primed ovarian stimulation in patients with no less than two implantation failures in long protocol. Methods: A retrospective study including 278 patients who had ≥2 implantation failures in long protocol and received PPOS subsequently was performed. The ovarian stimulation and pregnancy outcomes were compared between PPOS and previous long protocol. Results: For patients with ≥2 implantation failures of long protocol, the number of retrieved oocytes, viable embryos and the viable embryo rate per oocyte in PPOS were less than long protocol (P<0.05). In FET cycles of PPOS, these patients transferred less embryos per cycle than long protocol (P<0.01), with the clinical pregnancy rate, implantation rate and live birth rate of 49.2%, 31.4% and 41.7%. Among these specific women, patients who only received FET in previous long protocol gained the clinical pregnancy rate, implantation rate and live birth rate of 45.2%, 30.2% and 41.1% in FET cycles of PPOS. Conclusion: Patients with no less than two implantation failures in long protocol can obtain acceptable pregnancy outcomes in PPOS, and the possible reason may be the improvement in quanlity of oocytes and embryos. PPOS can be an efficient alternative protocol for these patients.

Key words： long protocol progestin primed ovarian stimulation controlled ovarian stimulation lutei-nizing hormone

Received: 04 March 2018

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHANG Yijia
	CHEN Qiuju
	KUANG Yanping.

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I7/529

[1] YU S, LONG H, CHANG H Y, et al. New application of dydrogesterone as a part of a progestin-primed ovarian stimulation protocol for IVF: a randomized controlled trial including 516 first IVF/ICSI cycles[J]. Hum Reprod, 2018, 33(2): 229-237.
[2] 郭丽娜, 贾新转, 吕翠婷, 等. 高孕激素状态下促排卵方案用于卵巢正常反应患者IVF-ET的自身对照研究[J]. 生殖医学杂志, 2017, 26(2): 127-132.
[3] VAN LOENEN A C, HUIRNE J A, SCHATS R, et al. GnRH agonists, antagonists, and assisted conception[J]. Semin Reprod Med, 2002, 20(4): 349-364.
[4] KUANG Y P, CHEN Q J, FU Y L, et al. Medroxyprogesterone acetate is an effective oral alternative for preventing premature luteinizing hormone surges in women undergoing controlled ovarian hyperstimulation for in vitro fertilization [J]. Fertil Steril, 2015, 104(1): 62-70.
[5] HE W, LI X, ADEKUNBI D, et al. Hypothalamic effects of progesterone on regulation of the pulsatile and surge release of luteinising hormone in female rats[J]. Sci Rep, 2017, 7 (1): 80-96.
[6] 叶静, 陈秋菊, 匡延平. 卵巢功能正常患者高孕激素状态下促排卵的内分泌特征及IVF/ICSI临床结局的研究[J]. 生殖与避孕, 2015, 35(6): 393-400.
[7] 张欣, 张玉, 王雪莹, 等. 高孕激素状态促排卵与长方案用于不同年龄组供精体外受精的结局[J]. 生殖医学杂志, 2017, 26(5): 452-456.
[8] CUMMINS J M, BREEN T M, HARRISON K L, et al. A formula for scoring human embryo growth rates in in vitro fertilization: its value in predicting pregnancy and in comparison with visual estimates of embryo quality[J]. J In Vitro Fert Embryo Transf, 1986, 3(5): 284-295.
[9] KUANG Y P, HONG Q Q, CHEN Q J, et al. Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles[J]. Fertil Steril, 2014, 101(1): 105-111.
[10] QIN N X, CHEN Q J, HONG Q Q, et al. Flexibility in starting ovarian stimulation at different phases of the menstrual cycle for treatment of infertile women with the use of in vitro fertilization or intracytoplasmic sperm injection[J]. Fertil Steril, 2016, 106(2): 334-341.
[11] 朱洁茹, 欧建平. 垂体降调节方案的不足及适用性探讨[J]. 生殖医学杂志, 2016, 25(10): 893-896.
[12] DRAKAKIS P, LOUTRADIS D, KALLIANIDIS K, et al. Small doses of LH activity are needed early in ovarian stimulation for better quality oocytes in IVF-ET[J]. Eur J Obstet Gynecol Reprod Biol, 2005, 121(1): 77-80.
[13] 宋娟, 龚斐, 罗克利, 等. GnRH激动剂长效剂型和短效剂型在长方案中的应用比较[J]. 生殖与避孕, 2015, 35(6): 389-392, 424.
[14] 罗颖怡, 邓明芬, 胡晓坤, 等. 不同降调节长方案GnRH-a剂量与LH水平的关系及临床结局的比较[J]. 中山大学学报(医学科学版), 2017, 38(2): 278-284.
[15] OLIVEIRA S A, CALSAVARA V F, CORTES G C. Final oocyte maturation in assisted reproduction with human chorionic gonadotropin and gonadotropin-releasing hormone agonist (dual trigger)[J]. JBRA Assist Reprod, 2016, 20(4): 246-250.
[16] GRIFFIN D, FEINN R, EENMANN L, et al. Dual trigger with gonadotropin-releasing hormone agonist and standard dose human chorionic gonadotropin to improve oocyte maturity rates[J]. Fertil Steril, 2014, 102(2): 405-409.
[17] DECLEER W, OSMANAGAOGLU K, SEYNHAVE B,
et al. Comparison of hCG triggering versus hCG in combination with a GnRH agonist: a prospective randomized controlled trial[J]. Facts Views Vis Obgyn, 2014, 6(4): 203-209.
[18] ALYASIN A, MEHDINEJADIANI S, GHASEMI M. GnRH agonist trigger versus hCG trigger in GnRH antagonist in IVF/ICSI cycles: A review article[J]. Int J Reprod Biomed (Yazd), 2016, 14(9): 557-566.
[19] HUMAIDAN P, POLYZOS N P, ALSBJERG B, et al. GnRHa trigger and individualized luteal phase hCG support according to ovarian response to stimulation: two prospective randomized controlled multi-centre studies in IVF patients [J]. Hum Reprod, 2013, 28(9): 2511-2521.
[20] HUMAIDAN P, EJDRUP BREDKJAER H, WESTERGAARD L G, et al. 1,500 IU human chorionic gonadotropin administered at oocyte retrieval rescues the luteal phase when gonadotropin-releasing hormone agonist is used for ovulation induction: a prospective, randomized, controlled study[J]. Fertil Steril, 2010, 93(3): 847-854.