Abstract:

Objective　To compare the clinical outcomes of fresh transfer cycles of in vitro fertilization-embryo transfer (IVF-ET) between follicular phase long-acting long protocol and luteal phase short-acting long protocol. Methods　The data of 313 patients taking IVF-ET (313 cycles) at Reproductive Medicine Center, Yantaishan Hospital from January 2018 to December 2022 were retrospectively analyzed. The cycles were divided into a folicular phase long-acting long protocol group (group A; 141 cycles) and a luteal phase short-acting long protocol group (group B; 172 cycles) according to the controlled ovarian stimulation protocols. Group A were (31.59±3.00) years old, with (3.48±2.38) years of infertility. Group B were (31.42±3.03) years old, with (3.38±2.38) years of infertility. The clinical outcomes were compared between the two groups by t and χ² tests. Results　The total dosage of gonadotropin (Gn), Gn days, and endometrial thickness on the human chorionic gonadotropin (HCG) administration day in group A were more than those in group B [(29.53±11.18) ones vs. (23.83±7.03) ones, (9.61±1.80) d vs. (8.44±1.26) d, and (1.13±0.23) cm vs. (1.06±0.26) cm], with statistical differences (t=5.49, 6.75, and 2.44; all P<0.05). The levels of estrogen and luteinizing hormone (LH) on the HCG administration day, oocyte retrieved rate, and high-quality embryo rate in group A were lower than those in group B [(2 255.00±1 417.75) ng/L vs. (2 787.01±1 285.11) ng/L, (1.56±1.34) mIU/ml vs. (2.12±1.02) mIU/ml, 81.00% (1 522/1 879) vs. 84.74% (2 043/2 411), and 38.31% (344/898) vs. 48.22% (597/1 238)], with statistical differences (t=3.44 and 4.14; χ²=10.50 and 20.76; all P<0.05). The clinical pregnancy rate and embryo implantation rate in group A were higher than those in group B [59.65% (68/114) vs. 43.88% (43/98) and 44.39% (87/196) vs. 31.82% (56/176)], with statistical differences (χ²=5.26 and 6.19; all P<0.05). Conclusion　The clinical pregnancy rate and embryo implantation rate of fresh transfer cycles are higher by the follicular phase long-acting long protocol than by the luteal phase short-acting long protocol.

Key words:

In vitro fertilization-embryo transfer, Folicular phase long-acting long protocol, Luteal phase short-acting long protocol, Clinical pregnancy rate, Embryo implantation rate

摘要：

比较体外受精-胚胎移植（IVF-ET）卵泡期长效长方案与黄体期短效长方案新鲜移植周期的临床结局。方法　回顾性分析2018年1月至2022年12月在烟台市烟台山医院生殖医学中心行IVF-ET助孕的313例患者（313个周期）资料，根据其促排卵方案分成两组。卵泡期长效长方案组（A组，141个周期），年龄（31.59±3.00）岁，不孕年限（3.48±2.38）年；黄体期短效长方案组（B组，172个周期），年龄（31.42±3.03）岁，不孕年限（3.38±2.38）年。应用t检验及χ²检验比较两种方案的临床结局。结果　A组总促性腺激素（Gn）用量、Gn天数、人绒毛膜促性腺激素（HCG）日内膜厚度均高于B组［（29.53±11.18）支比（23.83±7.03）支、（9.61±1.80）d比（8.44±1.26）d、（1.13±0.23）cm比（1.06±0.26）cm］，差异均有统计学意义（t=5.49、6.75、2.44，均P<0.05）；A组HCG日雌二醇（E₂）、HCG日黄体生成素（LH）水平、获卵率、优胚率均低于B组［（2 255.00±1 417.75）ng/L比（2 787.01±1 285.11）ng/L、（1.56±1.34）mIU/ml比（2.12±1.02）mIU/ml、81.00%（1 522/1879）比84.74%（2 043/2 411）、38.31%（344/898）比48.22%（597/1 238）］，差异均有统计学意义（t=3.44、4.14，χ²=10.50、20.76，均P<0.05）；A组临床妊娠率、胚胎着床率高于B组［59.65%（68/114）比43.88%（43/98）、44.39%（87/196）比31.82%（56/176）］，差异均有统计学意义（χ²=5.26、6.19，均P<0.05）。结论　卵泡期长效长方案新鲜移植周期临床妊娠率和胚胎着床率均高于黄体期短效长方案。

关键词:

体外受精-胚胎移植, 卵泡期长效长方案, 黄体期短效长方案, 临床妊娠率, 胚胎着床率