Impact of follicular size categories on oocyte quality at trigger day in young and advanced-age patients undergoing GnRH-ant therapy

作者全名："Yang, Jingwei; Gao, Jing; Wang, Yuting; Liu, Hongya; Lian, Xuemei"

作者地址："[Yang, Jingwei] Chongqing Med Univ, Ctr Reprod Med, Chongqing Key Lab Human Embryo Engn, Women & Childrens Hosp, Chongqing, Peoples R China; [Yang, Jingwei] Chongqing Hlth Ctr Women & Children, Chongqing Clin Res Ctr Reprod Med, Chongqing, Peoples R China; [Yang, Jingwei; Liu, Hongya; Lian, Xuemei] Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China; [Gao, Jing] Chongqing Med Univ, Dept Acad Affairs, Childrens Hosp, Chongqing, Peoples R China; [Wang, Yuting] Chongqing Med Univ, Dept Med Records & Stat, Affiliated Hosp 2, Chongqing, Peoples R China"

通信作者："Lian, XM (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China."

来源：FRONTIERS IN ENDOCRINOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000975718200001

JCR分区：Q2

影响因子：5.2

年份：2023

卷号：14

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：follicle size; oocyte quality; advanced age; GnRH-ant cycles; trigger

摘要："AimTo study the effect of follicle sizes of different proportions on oocyte and embryo quality in young and advanced-age patients, and provide evidence for personalized protocol adjustment. MethodsThis was a retrospective real-world data study including a total of 11,462 patients who had started their first in vitro fertilization cycle with a gonadotropin-releasing hormone antagonist (GnRH-ant) protocol during 2018-2021. We classified patients into groups according to the size of the dominant proportion of follicles on the human chorionic gonadotropin (hCG) trigger day: Large, Medium, Small, and Equal (containing equivalent proportions of all three size categories). The Cochran-Mantel-Haenszel test by different Anti-Mullerian Hormone (AMH) and antral follicle count (AFC) was used to compare factors such as the metaphase II (MII) oocyte rate, normal fertilization rate, and two pronuclei (2PN) cleavage rate between groups. General linear model (GLM) analysis was performed for inter-group comparison of the oocyte and embryo quality. ResultsIn patients aged < 35 years and with AMH >= 1.2 mu g/L, the MII oocyte percentages in the Large and Medium groups were significantly higher than in the Small group (P < 0.001). The germinal vesicle (GV) oocyte and unavailable oocyte percentages in the Large and Medium groups were lower than in the Small group (P < 0.001). Among patients aged >= 35 years with AFC < 5 and AMH >= 1.2 mu g/L, the GV oocyte percentage in the Large group was significantly lower than in the Medium group (2.54% vs. 4.46%, P < 0.001). In patients < 35 years, the GLM demonstrated that the Large and Medium groups had positively impacted on the development of MII oocyte and live birth rate(LBR) of first embryo transfer(ET)(beta>0, all P value < 0.05);and had less likely to develop into unavailable oocyte, degenerated oocyte, GV oocyte and MI oocyte rates relative to the Small group(beta<0, all P value < 0.05). And among patients >= 35 years, the Medium group had positively impacted on the development of MII oocyte and 2PN rates relative to the Small group(beta>0, all P value < 0.05); and had less likely to develop into MI oocytes relative to the Small group(beta<0, all P value < 0.05). The GLM indicated that AMH, along with Gn total dose, start dose, and Gn days, had significant impact on oocyte and embryo quality. For young patients, age was not a significant influencing factor, but for advanced-age patients, age influenced the outcomes. ConclusionOur analysis suggests that for young patients (< 35 years), triggering when there is a high proportion of large or medium follicles results in better quality oocytes, while for older patients (>= 35 years), it is better to trigger when the proportion of medium follicles is no less than that of small follicles. Further research is required to confirm these findings."

基金机构："Social Guarantee and Technical Innovation Foundation of Chongqing Province, China [cstc2017shms-zdyfx0020, CSTB2022TIAD-KPX0146]"

基金资助正文："Funding This study was supported by the Social Guarantee and Technical Innovation Foundation of Chongqing Province, China (cstc2017shms-zdyfx0020; CSTB2022TIAD-KPX0146)."