Abstract
Background The prevalence of infertility among Chinese women of reproductive age was estimated to be 25.0%. Currently, assisted reproductive technology, such as in vitro fertilization (IVF), is considered the most effective treatment for infertility. Cetrorelix is a subcutaneously administered gonadotropin-releasing hormone antagonist approved for clinical use in IVF therapy. To improve IVF outcomes, there is a need to identify predictive markers of successful clinical pregnancy with gonadotropin-releasing hormone antagonists.Methods The retrospective FASSION study assessed clinical outcomes and factors associated with clinical pregnancy rates of Chinese patients undergoing fertility treatment with cetrorelix and IVF/intracytoplasmic sperm injection (ICSI) cycles. We analyzed medical records of infertile women aged ≤35 years, with baseline serum follicle-stimulating hormone level ≤10 mIU/mL, body mass index ≤30 kg/m2 and normal uterine cavity, who underwent IVF/ICSI cycles using cetrorelix at four centers in China. The primary objective was identifying factors associated with clinical pregnancy rates by validating a predictive model for clinical outcome evaluation. Secondary objectives were clinical outcomes and safety.Results In total, 2972 women were included. After adjusting for confounders, on the day of human chorionic gonadotropin triggering, an increased endometrial thickness was associated with a higher probability of pregnancy outcome (p=0.0001) and a higher progesterone level was associated with a lower probability of pregnancy outcome after fresh embryo transfer (ET) per initiated cycle (p=0.0256). Per ET cycle, the ongoing pregnancy and clinical pregnancy rates were 45.2% and 53.0%, respectively, with an implantation rate of 37.3% per ET. The early miscarriage and cycle cancellation rates were 13.4% and 5.7%, respectively. A total of 970 live births were reported. The live birth rate per initiated cycle was 32.6% and that per ET cycle was 45.2%. Fifty-one patients (1.7%) reported an ovarian hyperstimulation syndrome event, with severe events in 17 (0.6%) patients.Conclusions This prediction model may be useful for the preliminary screening of IVF patients and help improve clinical pregnancy outcomes.
Prognostic factors associated with clinical pregnancy in in vitro fertilization using pituitary down-regulation with depot and daily low-dose luteal phase gonadotropin releasing hormone agonists: A single center′s experience
