Recombinant LH Supplementation Timing Strategies (From Day 1 or Day 6) to a Standard GnRH Agonist Long Protocol in Subsequent COS Cycle of Older Patients With Unexpected Poor or Suboptimal Ovarian Response

2019 ◽  
Author(s):  
Keyword(s):  
Gnrh Agonist ◽  
Older Patients ◽  
Ovarian Response ◽  
Timing Strategies ◽  
Long Protocol ◽  
Recombinant Lh

scholarly journals Comparison of the predictive value of progesterone‐related indicators for pregnancy outcomes of women undergoing the short‐acting GnRH agonist long protocol: a retrospective study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Yangyang Zhang ◽  
Yang Xu ◽  
Yuqiong Wang ◽  
Qing Xue ◽  
Jing Shang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gnrh Agonist ◽  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Ovarian Response ◽  
Clinical Pregnancy ◽  
Short Acting ◽  
Good Quality Embryo ◽  
Response Group ◽  
Long Protocol

Abstract Background There are many progesterone (P) elevation-related indicators for predicting pregnancy outcomes, including the serum P, P-to-oestradiol ratio (P/E2), P-to-follicle index (PFI), and P-to-mature oocyte index (PMOI); however, due to inconsistencies in study populations and controlled ovarian hyperstimulation (COH) protocols among studies, these indicators are controversial. Moreover, no researchers have included these four commonly used indicators in one study to compare their predictive efficacies. The objective of this study was to compare the predictive value of P-related indicators for pregnancy outcomes of women undergoing the short-acting GnRH agonist long protocol. Methods A total of 612 infertile women undergoing IVF/ICSI were recruited for this study. Serum samples were obtained on the morning of HCG injection for serum P and E2 measurements. Transvaginal ultrasound was performed to determine the follicle count (≥ 14 mm in diameter). The number of mature oocytes was observed in the embryo laboratory after oocyte retrieval. Results In cases of P < 2.5 ng/ml, there was no significant difference in the serum P level or P/E2 between the pregnant group and the non-pregnant group. The PFI and PMOI of the pregnant group were significantly lower than those of the non-pregnant group. According to the stratified analysis of the ovarian response, only the PMI and PMOI of the pregnant women in the normal ovarian response group were lower than those of the non-pregnant women. To compare the predictive value of the PFI and PMOI in IVF/ICSI outcomes, the patients were divided into four groups. The good-quality embryo rate and clinical pregnancy rate were highest in Group A (low PFI and low PMOI) and lowest in Group D (high PFI and high PMOI). In the two groups with discordant PFI and PMOI, namely Group B (low PFI and high PMOI) and Group C (high PFI and low PMOI), the good-quality embryo rate and clinical pregnancy rate were not significantly different. Conclusions The PFI and PMOI had equal value in predicting clinical pregnancy outcomes in the normal ovarian response group undergoing the short-acting GnRH agonist long protocol. Each clinical centre can choose one of the indicators according to their actual situation in clinical practice and establish individual cut-off values for PFI and PMOI based on their own hormonal measurements.

scholarly journals Comparison of the predictive value of progesterone-related indicators for pregnancy outcomes of women undergoing the short-acting GnRH agonist long protocol: a retrospective study

2021 ◽  
Author(s):  
Yangyang Zhang ◽  
Yang Xu ◽  
Yuqiong Wang ◽  
Qing Xue ◽  
Jing Shang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gnrh Agonist ◽  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Ovarian Response ◽  
Clinical Pregnancy ◽  
Short Acting ◽  
Good Quality Embryo ◽  
Response Group ◽  
Long Protocol

Abstract Background: There are many progesterone (P) elevation-related indicators for predicting pregnancy outcomes, including the serum P, P-to-oestradiol ratio (P/E2), P-to-follicle index (PFI), and P-to-mature oocyte index (PMOI); however, due to inconsistencies in study populations and controlled ovarian hyperstimulation (COH) protocols among studies, these indicators are controversial. Moreover, no researchers have included these four commonly used indicators in one study to compare their predictive efficacies. The objective of this study was to compare the predictive value of P-related indicators for pregnancy outcomes of women undergoing the short-acting GnRH agonist long protocol. Methods: A total of 612 infertile women undergoing IVF/ICSI were recruited for this study. Serum samples were obtained on the morning of HCG injection for serum P and E2 measurements. Transvaginal ultrasound was performed to determine the follicle count (≥ 14 mm in diameter). The number of mature oocytes was observed in the embryo laboratory after oocyte retrieval.Results: In cases of P<2.5 ng/ml, there was no significant difference in the serum P level or P/E2 between the pregnant group and the non-pregnant group. The PFI and PMOI of the pregnant group were significantly lower than those of the non-pregnant group. According to the stratified analysis of the ovarian response, only the PMI and PMOI of the pregnant women in the normal ovarian response group were lower than those of the non-pregnant women. To compare the predictive value of the PFI and PMOI in IVF/ICSI outcomes, the patients were divided into four groups. The good-quality embryo rate and clinical pregnancy rate were highest in Group A (low PFI and low PMOI) and lowest in Group D (high PFI and high PMOI). In the two groups with discordant PFI and PMOI, namely Group B (low PFI and high PMOI) and Group C (high PFI and low PMOI), the good-quality embryo rate and clinical pregnancy rate were not significantly different.Conclusions: The PFI and PMOI had equal value in predicting clinical pregnancy outcomes in the normal ovarian response group undergoing the short-acting GnRH agonist long protocol. Each clinical centre can choose one of the indicators according to their actual situation in clinical practice and establish individual cut-off values for PFI and PMOI based on their own hormonal measurements.

scholarly journals Comparison of the predictive value of progesterone-related indicators for pregnancy outcomes of women undergoing the short-acting GnRH agonist long protocol: a retrospective study

2020 ◽  
Author(s):  
Yangyang Zhang ◽  
Yang Xu ◽  
Yuqiong Wang ◽  
Qing Xue ◽  
Jing Shang ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Gnrh Agonist ◽  
Pregnancy Outcomes ◽  
Predictive Value ◽  
Ovarian Response ◽  
Clinical Pregnancy ◽  
Short Acting ◽  
Good Quality Embryo ◽  
Response Group ◽  
Long Protocol

Abstract Background There are many progesterone (P) elevation-related indicators for predicting pregnancy outcomes, including serum P, P-to-oestradiol ratio (P/E2), P-to-follicle index (PFI), and P-to-mature oocyte index (PMOI); however, due to inconsistencies in study populations and controlled ovarian hyperstimulation (COH) protocols among studies, these indicators are controversial. Moreover, no researchers have included these four commonly used indicators in one study to compare their predictive efficacies. The objective of this study was to compare the predictive value of P-related indicators for pregnancy outcome of women undergoing the short-acting GnRH agonist long protocol. Methods A total of 612 infertile women undergoing IVF/ICSI were recruited for this study. Serum samples were obtained on the morning of HCG injection for serum P and E2 measurements. Transvaginal ultrasound was performed to determine the follicle count (≥ 14 mm). The number of mature oocytes was observed in the embryo laboratory after oocyte retrieval. Results In cases of P < 2.5 ng/ml, there was no significant difference in the serum P level or P/E2 between the pregnant group and the non-pregnant group. The PFI and PMOI of the pregnant group were significantly lower than those of the non-pregnant group. According to the stratified analysis of the ovarian response, only the PMI and PMOI of the pregnant women in the normal ovarian response group were lower than those of the non-pregnant women. In order to compare the predictive value of the PFI and PMOI in IVF/ICSI outcomes, patients were divided into four groups. The good-quality embryo rate and clinical pregnancy rate were highest in Group A (low PFI and low PMOI) and lowest in Group D (high PFI and high PMOI). In the two groups with discordant PFI and PMOI, namely, Group B (low PFI and high PMOI) and Group C (high PFI and low PMOI), the good-quality embryo rate and clinical pregnancy rate were not significantly different. Conclusions PFI and PMOI had equal value in predicting clinical pregnancy outcomes in the normal ovarian response group undergoing the short-acting GnRH agonist long protocol. Each clinical centre can choose one of the indicators according to their actual situation in clinical practice.

Effect of the Timing of Frozen Embryo Transfer on Pregnancy Outcomes in High Ovarian Response Patients Undergoing Freeze-All Strategy

2020 ◽  
Author(s):  
Na Zuo ◽  
Yingzhuo Gao ◽  
Ningning Zhang ◽  
Da Li ◽  
Xiuxia Wang
Keyword(s):  
Propensity Score ◽  
Embryo Transfer ◽  
Subgroup Analysis ◽  
Pregnancy Outcomes ◽  
Ovarian Response ◽  
Frozen Embryo Transfer ◽  
Matched Cohort ◽  
Entire Cohort ◽  
Long Acting ◽  
Long Protocol

Abstract Background: Frozen embryo transfer (FET) can greatly improve the pregnancy outcomes for high ovarian response (HOR) population. However, it is not known whether the impaired endometrial receptivity derived from controlled ovarian hyperstimulation (COH) can be fully recovered in the first menstrual cycle after oocyte retrieval, and whether the timing of FET is a risk factor on pregnancy outcomes in HOR population undergoing freeze-all strategy.Methods: A retrospective cohort study to compare the pregnancy outcomes of the immediate and delayed FET groups in HOR population undergoing freeze-all strategy. Propensity score matching was used to make the potential risk factors of the immediate and delayed FET groups comparable. Multivariable regression analysis was used to study the effect of the timing of FET on pregnancy outcomes in the entire cohort and propensity score-matched cohort, even in different COH protocol cohorts as subgroup analysis.Results: We showed that the immediate FET group were no worse than delayed FET group in the entire cohort [clinical pregnancy rate (CPR), adjusted odd ratio (OR), 0.942, 95% confidence interval (CI), 0.784-1.133; spontaneous abortion rate (SAR), adjusted OR, 1.118, 95% Cl (0.771-1.623); live birth rate (LBR), adjusted OR, 1.060, 95% Cl (0.886-1.267)]. The same results were obtained by χ2 test in the propensity score-matched cohort (CPR, 60.5% versus 63.5%; SAR, 11.6% versus 12.3%; LBR, 48% versus 49.3%) (P > 0.05). Subgroup analysis indicated that pregnancy outcomes of immediate FET were non-inferior to delayed FET in short-acting gonadotropin-releasing hormone agonist (GnRH-a) long protocol (P > 0.05). The SAR of the immediate FET group were lower than that of the delayed FET group in GnRH antagonist protocol (adjusted OR, 0.646, 95% CI, 0.432-0.966) and long-acting GnRH-a long protocol (adjusted OR, 0.375, 95% CI, 0.142-0.990) (P < 0.05), no differences were observed in CPR and LBR (P > 0.05).Conclusions: These findings indicate that immediate FET might not affect pregnancy outcomes in HOR patients undergoing freeze-all strategy. Delaying FET could increase the SAR in GnRH-ant and long-acting GnRH-a long protocols.

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