GnRH Antagonist Protocol With Cessation of Cetrorelix on Trigger Day Improves Embryological Outcomes for Patients With Sufficient Ovarian Reserve.
GnRH Antagonist Protocol With Cessation of Cetrorelix on Trigger Day Improves Embryological Outcomes for Patients With Sufficient Ovarian Reserve.
复制标题
GnRH 拮抗剂方案在触发日停止西曲瑞克可改善卵巢储备充足患者的胚胎学结果
DOI：
10.3389/fendo.2021.758896
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发表时间：
2021
影响因子：
5.2
通讯作者：
Xu B
中科院分区：
文献类型：
--
作者：
Xu H;Zhao S;Gao X;Wu X;Xia L;Zhang D;Li J;Zhang A;Xu B
目的 评价在促性腺激素释放激素拮抗剂（GnRH-ant）控制的体外受精（IVF）周期卵巢刺激期间，触发日停止西曲瑞克的有效性和有效性。方法 在这项回顾性研究中，共有 1271 名按照 GnRH-ant 方案接受初始 IVF 周期的患者入组。 832 名患者在触发日接受西曲瑞克（A 组），439 名患者在触发日停止西曲瑞克（B 组）。我们比较了两组之间的人口特征、胚胎学和临床结果。泊松回归模型用于识别显着影响胚胎学结果的因素。根据抗苗勒氏管激素（AMH）和年龄将患者进一步分为亚组，以评估触发日停止西曲瑞克与胚胎学结果之间的关联。结果 在触发日停止西曲瑞克的患者的胚胎学结果有显着改善，并且两组之间的临床结果或排卵前率没有显着差异。此外，对于1.1≤AMH≤4.7ng/ml的患者，B组的所有胚胎学结果均显着高于A组。对于AMH>4.7ng/ml的患者，B组的获卵数、IVF周期的受精率（2PN）和第3天优质胚胎的比例均显着较高。对于年龄<35岁的患者，除可用胚胎数量外，所有胚胎学结果均显着高于A组。 B 组显着高于 A 组。当患者根据年龄 > 35 岁或 AMH < 1.1 ng/ml 进行分层时，两组之间的胚胎学结果没有差异。结论 在触发日停止西曲瑞克的 GnRH-ant 方案可改善年轻患者或卵巢储备充足患者的胚胎学结局，并能有效预防排卵前。
Objective To evaluate the efficiency and validity of cessation of cetrorelix on trigger day during gonadotropin releasing hormone antagonist (GnRH-ant)-controlled ovarian stimulation of in vitro fertilization (IVF) cycles. Methods In this retrospective study, a total of 1271 patients undergoing initial IVF cycles following the GnRH-ant protocol were enrolled; 832 patients received cetrorelix on trigger day (Group A) and 439 patients ceased cetrorelix on trigger day (Group B). We compared demographic characteristics, embryological and clinical outcomes between the two groups. A Poisson regression model was used to identify factors that significantly affected embryological outcomes. Patients were further divided into subgroups according to anti-Mullerian hormone (AMH) and age, to assess associations between ceasing cetrorelix on trigger day and embryological outcomes. Results There was a significant improvement on embryological outcomes in patients who ceased cetrorelix on trigger day, and there were no significant differences in clinical outcomes or preovulation rates between the two groups. Furthermore, for patients with 1.1 ≤ AMH ≤ 4.7 ng/ml, all embryological outcomes were significantly higher in Group B compared with Group A. For patients with AMH > 4.7 ng/ml, the number of oocytes retrieved, fertilization rate (2PN) of IVF cycles and proportion of day 3 good quality embryos were all significantly higher in Group B. For patients with age < 35 years, all the embryological outcomes, besides the number of available embryos, were significantly higher in Group B than in Group A. There were no differences in embryological outcomes between the two groups when patients were stratified based on age > 35 years or AMH < 1.1 ng/ml. Conclusion GnRH-ant protocol with cessation of cetrorelix on trigger day improved embryological outcomes for young patients or patients with sufficient ovarian reserve, and was effective at preventing preovulation.
影响因子：
4.5
作者：
Chang HJ;Lee JR;Jee BC;Suh CS;Kim SH
通讯作者：
Kim SH