METHODS: A retrospective comparative cohort analysis of 149 in vitro fertilization (IVF) cycles using the freeze-all strategy was conducted. The IVF cycles were stimulated with either a gonadotropin-releasing hormone antagonist or clomiphene citrate along with gonadotropin based on the patient\'s serum anti-Müllerian hormone level. Oocyte retrieval, fertilization, and embryo culture were performed following standard procedures. All good-quality blastocysts were cryopreserved and used for frozen-thawed embryo transfer (FET) in subsequent cycles. The fertilization, blastulation, and top-quality blastocyst development rates were calculated. The perinatal outcomes of FET cycles, gestational period, and birth weight were assessed.
RESULTS: The main outcome of this study was the top-quality blastocyst development rate, and the secondary outcomes were perinatal parameters (e.g., gestational period and birth weight) between the stimulation regimens. Despite the higher number of usable-quality embryos in the antagonist group, the blastocyst development rate remained comparable (p=0.105). Similarly, perinatal outcomes were comparable in subsequent FET cycles (p=0.538).
CONCLUSIONS: These findings suggest that the choice between antagonist and clomiphene citrate with gonadotropin as stimulation in controlled ovarian stimulation regimens may not affect the top-quality blastocyst development rate. The IVF outcomes (e.g., clinical pregnancy, miscarriage, and live birth rates) remained unaffected in subsequent FET cycles. Unlike fresh embryo transfer, the birth weight and gestational length were not associated with prior controlled ovarian stimulation regimens when the freeze-all strategy was used.
方法:使用冷冻全部策略对149个体外受精(IVF)周期进行了回顾性比较队列分析。根据患者的血清抗苗勒管激素水平,用促性腺激素释放激素拮抗剂或克罗米芬与促性腺激素刺激IVF周期。取卵,受精,和胚胎培养按照标准程序进行。将所有优质胚泡冷冻保存,并在随后的周期中用于冻融胚胎移植(FET)。受精,囊胚形成,并计算出优质囊胚发育率。FET周期的围产期结局,妊娠期,评估出生体重。
结果:这项研究的主要结果是最高质量的胚泡发育率,次要结局是围产期参数(例如,妊娠期和出生体重)之间的刺激方案。尽管拮抗剂组中可用质量的胚胎数量较多,囊胚发育率保持相当(p=0.105)。同样,在随后的FET周期中,围产期结局具有可比性(p=0.538).
结论:这些研究结果表明,在控制性卵巢刺激方案中,选择拮抗剂和含有促性腺激素的克罗米芬作为刺激可能不会影响最高质量的胚泡发育率。IVF结果(例如,临床妊娠,流产,和活产率)在随后的FET周期中未受到影响。不像新鲜胚胎移植,当采用冷冻-全部策略时,出生体重和妊娠长度与之前的控制性卵巢刺激方案无关.