Effect of different triggers on clinical outcomes in patients with polycystic ovary syndrome undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer with antagonist regimen

doi:10.3877/cma.j.issn.1674-0785.2020.12.003

Abstract

Abstract:

Objective

To compare the effect of three different triggers (HCG, GnRHa, HCG+GnRHa) on in vitro fertilization outcome in patients with polycystic ovary syndrome (PCOS).

Methods

A retrospective analysis was performed on 854 PCOS patients treated with antagonist regimen from January 2017 to April 2020. According to the trigger(s) used, the patients were divided into three groups: HCG group (406 cases, HCG trigger), GnRHa group (222 cases, GnRHa trigger), and HCG+GnRHa group (226 cases, dual triggers). The number of retrieved oocytes, fertilization rate, cleavage rate, transplantable embryos, high qualified embryo rate, and OHSS rate were compared among the three groups.

Results

There were no statistically significant differences among the three groups in general characteristics and cleavage rate (P＞0.05). The number of retrieved oocytes [(21.71±6.84), (21.68±7.97) vs (16.03±7.04)], fertilization rate (68.32%, 69.26% vs 65.15%), transplantable embryos [(7.88±3.36), (8.09±3.21) vs (5.85±2.89)], and high qualified embryo rate (83.31%、83.27% vs 77.00%) in the GnRHa group and HCG+GnRHa group were significantly higher compared with those of the HCG group (P＜0.05), although there was no significant difference between the GnRHa group and HCG+GnRHa group (P＞0.05). The rates of OHSS in the GnRHa group and GnRHa+HCG group were significantly lower than that of the HCG group (4.50%, 4.87% vs 9.36%, P＜0.05), but there was no significant difference between the GnRHa group and HCG+GnRHa group (P＞0.05).

Conclusion

Dual trigger can decrease the rate of severe OHSS and increase the number of high quality embryos.

Key words: Polycystic ovary syndrome, Antagonism, Ovarian hyperstimulation syndrome

Zhaojuan Yu, Caihua Li, Yan Hao, Zhaolian Wei. Effect of different triggers on clinical outcomes in patients with polycystic ovary syndrome undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer with antagonist regimen[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(12): 967-971.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2020.12.003

https://zhlcyszz.cma-cmc.com.cn/EN/Y2020/V14/I12/967

Figures/Tables 3

组别	例数	年龄（岁）	不孕年限（年）	BMI（kg/m²）	原发不孕[例（%）]	基础FSH（U/L）	基础LH（U/L）	基础E2（pmol/L）
HCG组	406	27.97±3.22	3.34±1.64	23.77±3.59	273（67.24）	6.12±1.45	9.26±6.34	155.60±102.37
GnRHa组	222	27.60±3.32	3.16±1.71	23.17±3.12	147（66.22）	5.88±1.71	10.30±5.86	165.09±101.62
HCG+GnRHa组	206	27.83±3.38	3.04±1.65	23.53±3.23	152（67.25）	6.03±1.53	9.57±5.62	169.34±102.05
统计值		F=0.917	F=2.44	F=2.664	χ²=3.505	F=1.733	F=2.157	F=1.479
P值		0.400	0.087	0.070	0.173	0.177	0.116	0.228

组别	例数	Gn天数（d, $x ¯$ ±s）	Gn总量（U, $x ¯$ ±s）	获卵数（个, $x ¯$ ±s）	受精率[%（n/N）]
HCG组	406	9.68±1.66	1 758.37±457.07	16.03±7.04	65.15（4239/6507）
GnRHa组	222	9.65±1.28	1 639.58±447.61^a	21.71±6.84^a	68.32（3293/4820）^a
HCG+GnRHa组	226	9.64±1.28	1 650.43±422.28^a	21.68±7.97^a	69.26（3393/4899）^a
统计值		F=0.090	F=6.919	F=62.147	χ²=24.553
P值		0.914	0.001	＜ 0.001	＜ 0.001
组别	例数	卵裂率[%（n/N）]	可移植胚胎数（个, $x ¯$ ±s）	优质胚胎数（个, $x ¯$ ±s）	优胚率[%（n/N）]
HCG组	406	95.03（4028/4239）	5.85±2.89	4.50±2.40	77.00（1828/2374）
GnRHa组	222	95.35（3140/3293）	7.88±3.36^a	6.57±2.74^a	83.31（1458/1750）^a
HCG+GnRHa组	226	95.87（3253/3393）	8.09±3.21^a	6.74±2.79^a	83.27（1523/1829）^a
统计值		χ²=3.116	F=50.951	F=73.310	χ²=36.380
P值		0.211	＜ 0.001	＜ 0.001	＜ 0.001

组别	例数	Gn天数（d, $x ¯$ ±s）	Gn总量（U, $x ¯$ ±s）	获卵数（个, $x ¯$ ±s）	受精率[%（n/N）]
HCG组	406	9.68±1.66	1 758.37±457.07	16.03±7.04	65.15（4239/6507）
GnRHa组	222	9.65±1.28	1 639.58±447.61^a	21.71±6.84^a	68.32（3293/4820）^a
HCG+GnRHa组	226	9.64±1.28	1 650.43±422.28^a	21.68±7.97^a	69.26（3393/4899）^a
统计值		F=0.090	F=6.919	F=62.147	χ²=24.553
P值		0.914	0.001	＜ 0.001	＜ 0.001
组别	例数	卵裂率[%（n/N）]	可移植胚胎数（个, $x ¯$ ±s）	优质胚胎数（个, $x ¯$ ±s）	优胚率[%（n/N）]
HCG组	406	95.03（4028/4239）	5.85±2.89	4.50±2.40	77.00（1828/2374）
GnRHa组	222	95.35（3140/3293）	7.88±3.36^a	6.57±2.74^a	83.31（1458/1750）^a
HCG+GnRHa组	226	95.87（3253/3393）	8.09±3.21^a	6.74±2.79^a	83.27（1523/1829）^a
统计值		χ²=3.116	F=50.951	F=73.310	χ²=36.380
P值		0.211	＜ 0.001	＜ 0.001	＜ 0.001

组别	例数	总OHSS发生情况	轻度OHSS	中度OHSS	重度OHSS
HCG组	406	38（9.36）	18（4.43）	12（2.96）	8（1.97）
GnRHa组	222	10（4.50）^a	5（2.25）	5（2.25）	0（0）^a
HCG+GnRHa组	226	11（4.87）^a	5（2.21）	6（2.65）	0（0）^a
χ²值		7.252	-
P值		0.027	0.252

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