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Abstract：
Objective The objective of this study was to determine if gonadotropin-releasing hormone agonist (GnRH-a) or gonadotropin-releasing hormone antagonist (GnRH-ant) protocols during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment in young infertile women improve their pregnancy outcomes. Methodology We retrospectively reviewed the records of 876 young infertile women aged 20-35 years who underwent fresh embryo transfer in IVF/ICSI cycles. The data were collected from their initial visits to the reproductive medicine center of the Second Affiliated Hospital of Zhengzhou University between January 2019 and December 2022. We divided them into two groups according to the controlled ovarian hyperstimulation (COH) protocols: GnRH-a (n = 580) and GnRH-ant (n = 296). The primary outcome assessed in this study was the live birth rate. The secondary observation indicators included the total dose and duration of gonadotropin (Gn), total embryo transfer, day three (D3) embryo transfer, total two pro-nuclei (2PN) cleavage count, number of fertilizations, and implantation rate. Results The live birth rate had no clinical significance (P > 0.05). The total dose and duration of Gn stimulation in the GnRH-ant group were lower than in the GnRH-a group (P < 0.05). The total embryo transfer, D3 embryo transfer, total cleavage count, total 2PN cleavage count, number of fertilizations, transfer, and mature oocytes in metaphase II (MII) of D3 embryos in the GnRH-a group were higher than those in the GnRH-ant group (P < 0.05). The clinical pregnancy rate and implantation rate of the GnRH-a group were higher than those of the control group. Conclusions The total embryo transfer, D3 embryo transfer, total cleavage count, total 2PN cleavage count, number of fertilizations, transfer and MII of D3 embryos, clinical pregnancy, and implantation rates were significantly higher in the GnRH-a protocol group. The total dosage of Gn and duration of Gn stimulation were lower in the GnRH-ant group than in the GnRH-a group. These findings provide the basis for the selection of the COH protocol in normal Chinese ovarian response patients undergoing IVF/ICSI.
摘要：
目的本研究的目的是确定促性腺激素释放激素激动剂（GnRH-a）或促性腺激素释放激素拮抗剂（GnRH-ant）方案在体外受精（IVF）或卵胞浆内单精子注射（ICSI）治疗中是否可以改善其妊娠结局。方法我们回顾性回顾了876名年龄在20-35岁之间的年轻不孕妇女在IVF/ICSI周期中接受新鲜胚胎移植的记录。数据来自他们于2019年1月至2022年12月在郑州大学第二附属医院生殖医学中心的初次访问。我们根据控制性卵巢过度刺激（COH）方案将其分为两组：GnRH-a（n=580）和GnRH-ant（n=296）。这项研究评估的主要结果是活产率。次要观察指标包括促性腺激素（Gn）的总剂量和持续时间，全胚胎移植,第三天（D3）胚胎移植，总共两个前核（2PN）分裂计数，施肥次数,和植入率。结果活产率无临床意义(P>0.05)。GnRH-ant组Gn刺激总剂量和持续时间均低于GnRH-a组(P<0.05)。整个胚胎移植，D3胚胎移植，总卵裂计数，总2PN分裂计数，施肥次数,转让,GnRH-a组的D3胚胎中期II（MII）成熟卵母细胞高于GnRH-ant组（P<0.05）。GnRH-a组的临床妊娠率和种植率均高于对照组。结论全胚胎移植,D3胚胎移植，总卵裂计数，总2PN分裂计数，施肥次数,D3胚胎的移植和MII，临床妊娠,GnRH-a方案组的植入率明显更高。GnRH-ant组的Gn总剂量和Gn刺激持续时间低于GnRH-a组。这些发现为在接受IVF/ICSI的正常中国卵巢反应患者中选择COH方案提供了基础。
