Endometrial but not Ovarian Response is Associated With Clinical Outcomes and can be Improved by Prolonged Pituitary Downregulation in Patients With Thin and Medium Endometrium
Endometrial but not Ovarian Response is Associated With Clinical Outcomes and can be Improved by Prolonged Pituitary Downregulation in Patients With Thin and Medium Endometrium
复制标题
DOI：
10.1177/1933719118816835
复制
发表时间：
2019-11-01
影响因子：
2.9
通讯作者：
Qian, Kun
中科院分区：
文献类型：
--
作者：
Song, Jianyuan;Sun, Xuejiao;Qian, Kun
本研究的目的是探讨卵巢和子宫内膜反应对年轻、正常和高反应者的活产率的影响，以及不同子宫内膜厚度患者的垂体长时间下调对子宫内膜容受性和临床结局的影响。2013年1月至2017年12月，9511例患者接受了首次体外受精(IVF)/卵母细胞浆内单精子注射(ICSI)周期，年龄=4个获卵数。将人绒毛膜促性腺激素(HCG)日的雌二醇(E-2)水平分为4组：第1组(=7000pg/mL)。对活产的自变量进行Logistic回归分析。比较促性腺激素释放激素激动剂(GnRH-a)长方案和GnRH-a长方案对不同子宫内膜厚度(EMT)患者的临床疗效。4组间植入率、临床妊娠率、LBR差异无统计学意义(P>；0.05)。二元Logistic回归分析表明，子宫肌瘤而不是E-2水平是LBRS的独立预测因素之一(优势比0.889，95%可信区间0.865-0.914，P<；0.001)。延长方案在中等(7<；EMT<；14 mm)，尤其是薄子宫内膜(
The aim of this study is to investigate the effect of ovarian and endometrial response on live birth rates (LBRs) in young normal and high responders and prolonged pituitary downregulation on endometrial receptivity and clinical outcomes in patients with different endometrial thickness. Between January 2013 and December 2017, 9511 patients underwent first in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles with age = 4 retrieved oocytes were conducted. The estradiol (E-2) levels on the human chorionic gonadotropin (HCG) day were classified into 4 groups: group 1 (= 7000 pg/mL). Logistic regression analysis was performed to predict the independent variables for live birth. Clinical outcomes between gonadotropin-releasing hormone agonist (GnRH-a) long protocol and GnRH-a prolonged protocol in patients with different endometrial thickness (EMT) were compared. There were no significant differences among the 4 groups in implantation rates, clinical pregnancy rates, and LBRs (P > .05). Binary logistic regression analysis suggested that EMT but not E-2 levels was one of the independent predictive factors of LBRs (odds ratio 0.889, 95% confidence interval, 0.865-0.914, P < .001). The prolonged protocol had significantly higher implantation rates and clinical pregnancy rates in patients with medium (7 < EMT < 14 mm), especially thin endometrium (