An Individualized Recommendation for Controlled Ovary Stimulation Protocol in Women Who Received the GnRH Agonist Long-Acting Protocol or the GnRH Antagonist Protocol: A Retrospective Cohort Study

作者全名："Chen, Ming-Xing; Meng, Xiang-Qian; Zhong, Zhao-Hui; Tang, Xiao-Jun; Li, Tian; Feng, Qian; Adu-Gyamfi, Enoch Appiah; Jia, Yan; Lv, Xing-Yu; Geng, Li-Hong; Zhu, Lin; He, Wei; Wan, Qi; Ding, Yu-Bin"

作者地址："[Chen, Ming-Xing; Zhong, Zhao-Hui; Ding, Yu-Bin] Chongqing Med Univ, Women & Childrens Hosp, Dept Obstet & Gynecol, Chongqing, Peoples R China; [Chen, Ming-Xing; Adu-Gyamfi, Enoch Appiah; Ding, Yu-Bin] Minist Educ China, Joint Int Res Lab Reprod & Dev, Sch Publ Hlth, Chongqing, Peoples R China; [Meng, Xiang-Qian; Lv, Xing-Yu; Wan, Qi] Chengdu Xinan Gynecol Hosp, Reprod Med Ctr, Chengdu, Peoples R China; [Zhong, Zhao-Hui; Tang, Xiao-Jun] Chongqing Med Univ, Res Ctr Med & Social Dev, Innovat Ctr Social Risk Governance Hlth, Sch Publ Hlth & Management,Dept Epidemiol, Chongqing, Peoples R China; [Li, Tian] Chongqing Med Univ, Affiliated Hosp 1, Dept Reprod Med, Chongqing, Peoples R China; [Feng, Qian] Chongqing Hosp Tradit Chinese Med, Dept Gynecol, Chongqing, Peoples R China; [Jia, Yan; Geng, Li-Hong] Chengdu Jinjiang Hosp Womens & Childrens Hlth, Infertil & Infertil Ctr, Chengdu, Peoples R China; [Zhu, Lin; He, Wei] Army Med Univ, Mil Med Univ 3, Southwest Hosp, Reprod Med Ctr, Chongqing, Peoples R China"

通信作者："Ding, YB (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Dept Obstet & Gynecol, Chongqing, Peoples R China.; Ding, YB (通讯作者)，Minist Educ China, Joint Int Res Lab Reprod & Dev, Sch Publ Hlth, Chongqing, Peoples R China.; Wan, Q (通讯作者)，Chengdu Xinan Gynecol Hosp, Reprod Med Ctr, Chengdu, Peoples R China.; He, W (通讯作者)，Army Med Univ, Mil Med Univ 3, Southwest Hosp, Reprod Med Ctr, Chongqing, Peoples R China."

来源：FRONTIERS IN ENDOCRINOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000837250300001

JCR分区：Q1

影响因子：5.2

年份：2022

卷号：13

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：GnRH agonist long-acting protocol; GnRH antagonist protocol; live birth rate; ovarian reserve; body mass index

摘要："BackgroundThe GnRH agonist long-acting protocol and GnRH antagonist protocol are widely used in ovarian stimulation. Which protocol eliciting higher live birth rate for IVF/ICSI patients with different ages, different ovarian reserves and different body mass index (BMI) has not been studied. However, among these protocols, the one that elicits higher live birth in IVF/ICSI patients with different ages, ovarian reserves and body mass indexes (BMI) has not been identified. MethodsThis was a retrospective cohort study about 8579 women who underwent the first IVF-ET from January, 2018 to August, 2021. Propensity Score Matching (PSM) was used to improve the comparability between two protocols. ResultsAfter PSM, significant higher live birth rates were found in the GnRH agonist long-acting protocol compared to GnRH antagonist protocol (44.04% vs. 38.32%) (p<0.001). Stratified analysis showed that for those with AMH levels between 3 ng/ml and 6 ng/ml, with BMI >= 24 kg/m(2) and were aged >= 30 years old, and for those women with BMI < 24kg/m(2) and were aged >= 30 years whose AMH levels were <= 3ng/ml, the GnRH agonist long-acting protocol was more likely to elicit live births [OR (95%CI), 2.13(1.19,3.80)], [OR (95%CI), 1.41(1.05,1.91)]. However, among women with BMI >= 24kg/m(2) and were aged >= 30 years whose AMH levels were <= 3ng/ml, the GnRH agonist long-acting protocol had a lower possibility of eliciting live births [OR (95%CI), 0.54(0.32,0.90)]. Also, among women with AMH levels between 3 ng/ml and 6 ng/ml, with BMI >= 24 kg/m(2) and with age < 30 years and for those with AMH levels between 3 ng/ml and 6 ng/ml, regardless of age, and with BMI<24kg/m2,, the possibility of live births was similar between the two protocols [OR (95%CI), 1.06(0.60,1.89)], [OR (95%CI), 1.38(0.97,1.97)], [OR (95%CI), 0.99(0.72,1.37)]. Among the women with AMH levels <= 3 ng/ml and with were aged < 30years, regardless of BMI, the possibility of live birth was similar between the two protocols [OR (95%CI), 1.02(0.68,1.54)], [OR (95%CI), 1.43(0.68,2.98)]. Moreover, among women with AMH levels >= 6ng/ml, the possibility of live birth was similar between the two protocols [OR (95%CI),1.42(0.75,2.69)], [OR (95%CI),1.02(0.19,5.35)], [OR (95%CI), 1.68(0.81,3.51)], [OR (95%CI), 0.51(0.10,2.55)]. ConclusionsThe suitability of the GnRH agonist long-acting protocol or GnRH antagonist protocol to infertility patients is dependent on specific biological characteristics of the patients."

基金机构：National Natural Science Foundation of China [81971391]; National Key Research and Development Program of China [2017YFC1002001]; Chongqing Science and Technology Bureau [cstc2019jxjl130030]

基金资助正文："This study was funded by the the National Natural Science Foundation of China (Grant No. 81971391), National Key Research and Development Program of China (2017YFC1002001), and the Chongqing Science and Technology Bureau (Grant No. cstc2019jxjl130030)."