Effect of GnRH agonist trigger with or without low-dose hCG on reproductive outcomes for PCOS women with freeze-all strategy: a propensity score matching study

作者全名："Wang, Qiaofeng; Wan, Qi; Li, Tian; Wang, Xuejiao; Hu, Yuling; Zhong, Zhaohui; Pu, Kexue; Ding, Yubin; Tang, Xiaojun"

作者地址："[Wang, Qiaofeng; Zhong, Zhaohui; Tang, Xiaojun] Chongqing Med Univ, Sch Publ Hlth, Dept Epidemiol, Chongqing, Peoples R China; [Wang, Qiaofeng] Chongqing Univ, Three Gorges Hosp, Chongqing, Peoples R China; [Ding, Yubin] Chongqing Med Univ, Sch Publ Hlth, Joint Int Res Lab Reprod & Dev, Minist Educ China, Chongqing, Peoples R China; [Pu, Kexue] Chongqing Med Univ, Coll Med Informat, Chongqing Engn Res Ctr Clin Big Data & Drug Evalua, Chongqing, Peoples R China; [Wang, Xuejiao; Hu, Yuling] Chengdu Jinjiang Hosp Womens & Childrens Hlth, Dept Reprod Ctr, Chengdu, Peoples R China; [Li, Tian] Chongqing Med Univ, Dept Reprod Med, Affiliated Hosp 1, Chongqing, Peoples R China; [Ding, Yubin] Chongqing Med Univ, Women & Childrens Hosp, Dept Obstet & Gynecol, Chongqing, Peoples R China; [Wan, Qi] Sichuan Univ, West China Hosp 2, Dept Gynecol & Obstet, Chengdu, Sichuan, Peoples R China; [Wan, Qi] Sichuan Univ, Key Lab Birth Defects & Related Dis Women & Childr, Minist Educ, Chengdu, Sichuan, Peoples R China"

通信作者："Tang, XJ (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Dept Epidemiol, Chongqing, Peoples R China.; Ding, YB (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Joint Int Res Lab Reprod & Dev, Minist Educ China, Chongqing, Peoples R China.; Ding, YB (通讯作者)，Chongqing Med Univ, Women & Childrens Hosp, Dept Obstet & Gynecol, Chongqing, Peoples R China."

来源：ARCHIVES OF GYNECOLOGY AND OBSTETRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001123664100001

JCR分区：Q2

影响因子：2.1

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：GnRH agonist; hCG; PCOS; Freeze-all strategy; Propensity score matching

摘要："Purpose This study aimed to compare the effect of gonadotropin-releasing hormone agonist (GnRHa) trigger alone versus dual trigger comprising GnRHa and low-dose human chorionic gonadotropin (hCG) on reproductive outcomes in patients with polycystic ovary syndrome (PCOS) who received the freeze-all strategy.Methods A total of 615 cycles were included in this retrospective cohort study. Propensity score matching (PSM) was performed to control potential confounding factors between GnRHa-trigger group (0.2 mg GnRHa) and dual-trigger group (0.2 mg GnRHa plus 1000/2000 IU hCG) in a 1:1 ratio. Multivariate logistic regression was applied to estimate the association between trigger methods and reproductive outcomes.Results After PSM, patients with dual trigger (n = 176) had more oocytes retrieved, mature oocytes, and 2PN embryos compared to that with GnRHa trigger alone. However, the oocytes maturation rate, normal fertilization rate, and frozen embryos between the two groups were not statistically different. The incidence of ovarian hyperstimulation syndrome (OHSS) (14.8% vs. 2.8%, P < 0.001) and moderate/severe OHSS (11.4% vs. 1.7%, P < 0.001) were significantly higher in dual-trigger group than in GnRHa-alone group. Logistic regression analysis showed the adjusted odds ratio of dual trigger was 5.971 (95% confidence interval 2.201-16.198, P < 0.001) for OHSS. The pregnancy and single neonatal outcomes were comparable between the two groups (P > 0.05).Conclusion For PCOS women with freeze-all strategy, GnRHa trigger alone decreased the risk of OHSS without damaging oocyte maturation and achieved satisfactory pregnancy outcomes."

基金机构："Chongqing Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning Science and Technology Research Institute"

基金资助正文：No Statement Available