Luteinizing Hormone Suppression by Progestin-Primed Ovarian Stimulation Is Associated With Higher Implantation Rate for Patients With Polycystic Ovary Syndrome Who Underwent in vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: Comparing With Short Protocol.
Luteinizing Hormone Suppression by Progestin-Primed Ovarian Stimulation Is Associated With Higher Implantation Rate for Patients With Polycystic Ovary Syndrome Who Underwent in vitro Fertilization/Intracytoplasmic Sperm Injection Cycles: Comparing With Short Protocol.
复制标题
DOI：
10.3389/fphys.2021.744968
复制
发表时间：
2021
影响因子：
4
通讯作者：
Long H
中科院分区：
文献类型：
--
作者：
Chen C;Yu S;Yu W;Yan Z;Jin W;Si J;Li M;Cai R;Li D;Wang L;Chen Q;Kuang Y;Lyu Q;Long H
多项研究表明，孕激素诱导的卵巢刺激(PPOS)在多囊卵巢综合征(PCOS)患者辅助生殖技术治疗中具有积极的临床价值。然而，造成这一现象的根本因素仍不清楚。我们进行了一项回顾性观察性研究，以比较接受PPO或短方案的PCOS妇女的临床结果，以确定影响结果的可能因素。这项研究包括2014年4月至2019年7月期间接受PPO的304名患者和接受短方案治疗的152名患者。比较了人类绝经期促性腺激素(HMG)剂量、激素谱、胚胎发育和冻融胚胎移植(FET)周期的临床结果。主要的结果衡量标准是种植率。用Logistic回归分析影响因素，用受试者工作特征曲线分析计算黄体生成素(L H)在临床结局中的差值。与短方案相比，PPO有更高的种植率(43.4%比31.9%，P<；0.05)、临床妊娠率(61.8%比47.4%，P；0.05)和活产率(48.4%比36.8%，P<；0.05)。不同组间的受精率、卵裂率和每卵母细胞的有效胚胎率相似。促黄体生成素差异率与种植率呈正相关[P=0.027，优势比(OR)=1.861，95%CI：1.074~3.226]。通过受试者工作特征曲线分析和按黄体生成素差值分组的患者之间的比较，证实了黄体生成素差值比与临床结果的关系。多囊卵巢综合征患者促排卵时的黄体生成素差值与着床率有关。我们的结果解释了为什么PPOS对多囊卵巢综合征患者显示出积极的临床结果。
Many studies have demonstrated the positive clinical value of progestin-primed ovarian stimulation (PPOS) in patients with polycystic ovary syndrome (PCOS) who underwent assisted reproductive technology. However, the underlying factors contributing to this phenomenon remain unclear. We conducted a retrospective observational study to compare the clinical outcomes of women with PCOS who underwent PPOS or the short protocol to identify possible factors that influence the outcome. This study included 304 patients who underwent PPOS and 152 patients who underwent short protocol from April 2014 to July 2019 after propensity-score matching. Human menopausal gonadotropin (hMG) dose, hormone profile, embryo development, and clinical outcomes of frozen-thawed embryo transfer (FET) cycles were compared. The primary outcome measure was the implantation rate. Logistic regression was performed to identify contributing factors, and receiver operating characteristic curve analysis was used to calculate the cutoff of luteinizing hormone (LH) difference ratio in clinical outcomes. Compared with the short protocol, PPOS resulted in a higher implantation rate (43.4% vs. 31.9%, P < 0.05), clinical pregnancy rate (61.8% vs. 47.4%, P < 0.05), and live birth rate (48.4% vs. 36.8%, P < 0.05). Similar fertilization, cleavage, and valid embryo rate per oocyte retrieved between groups were observed. The LH difference ratio was positively associated with implantation rate [P = 0.027, odds ratio (OR) = 1.861, 95% CI: 1.074–3.226]. The relationship between the LH difference ratio with clinical outcomes was confirmed by receiver operating characteristic curve analysis and comparisons among patients grouped by the LH difference ratio. The implantation rate was associated with the LH difference ratio during ovary stimulation in patients with PCOS. Our results provide the explanation why PPOS shows the positive clinical outcomes for patients with PCOS.
登录
查看更多内容
影响因子：
82.9
作者：
Cha J;Sun X;Dey SK
通讯作者：
Dey SK
每天使用 4 毫克与 10 毫克醋酸甲羟孕酮进行孕激素引发的卵巢刺激对接受体外受精的不孕妇女的妊娠结局：一项随机对照试验
DOI：
10.1111/1471-0528.14622
发表时间：
2017-06-01
影响因子：
5.8
作者：
Dong, J.;Wang, Y.;Kuang, Y. P.
通讯作者：
Kuang, Y. P.
影响因子：
13.3
作者：
Balen, Adam H.;Morley, Lara C.;Teede, Helena
通讯作者：
Teede, Helena
影响因子：
6.1
作者：
Fauser, BCJM;Chang, J;Lobo, R
通讯作者：
Lobo, R
影响因子：
81.5
作者：
Azziz, Ricardo;Carmina, Enrico;Yildiz, Bulent O.
通讯作者：
Yildiz, Bulent O.