促性腺激素释放激素拮抗剂方案与超短方案对卵巢储备功能低下患者行体外受精-胚胎移植妊娠结局的影响

Objective: To evaluate the effect of gonadotropin-releasing hormone antagonist (GnRH-A) protocol on in vitro fertilization-embryo transfer (IVF-ET) in patients with diminished ovarian reserve (DOR). Methods: A retrospective cohort study was performed to analyze the clinical data of the DOR patients who received IVF-ET treatment for the first time at the Northwest Women's and Children's Hospital Reproductive Center during January 2015 to December 2016. They were divided into a GnRH-A protocol group and an gonadotropin-releasing hormone agonist (GnRH-a) short protocol group according to different ovulation induction protocols. The general conditions, clinical and laboratory indicators, and pregnancy outcomes of the two groups were compared. Results: There was no statistically significant difference in live birth rate, clinical pregnancy rate and implantation rate between the two groups (P>0.05). The dosage of gonadotropin (Gn) used in GnRH-A protocol group [(3 082.04±1 004.40) IU] was less than that in GnRH-a short protocol group [(3 510.05±1 119.09) IU], P<0.001], the duration of Gn used [(9.66±2.13) d] was shorter than that in GnRH-a short protocol group [(10.63±2.27) d, P<0.001], the number of eggs (4.54±2.97) was less than that in GnRH-a short protocol group (5.54±3.54, P<0.001). Conclusion: DOR patients using GnRH-A protocol for hyperovulation therapy have similar outcomes to GnRH-a short protocol pregnancy, with less Gn used dosage and shorter Gn used duration. Therefore, the GnRH-A protocol is also one of the suitable ovulation induction for DOR patients.