Influence of female age on the fresh cycle live birth rate of different controlled ovarian hyperstimulation protocols in poor ovarian response patients
- Author:
- No author available
- Journal Title:
- Chinese Journal of Obstetrics and Gynecology
- Issue:
- 7
- DOI:
- 10.3760/cma.j.cn112141-20210219-00084
- Key Word:
- 不育，女（雌）性;年龄因素;排卵诱导;妊娠率;临床方案;卵巢低反应;活产率;Infertility, female;Age factors;Ovarian induction;Pregnancy rate;Clinical protocols;Poor ovarian response;Live birth rate
Abstract： Objective:To investigate the influence of age on the fresh cycle live birth rate in patients with poor ovarian response in different controlled ovarian hyperstimulation groups.Methods:The clinical data of 3 342 patients in The First Affiliated Hospital of Zhengzhou University from February 2014 to November 2018 were retrospectively collected, including early-follicular phase long-acting gonadotropin-releasing hormone (GnRH) agonist long protocol group (1 375 cases), mid-luteal phase short-acting GnRH agonist long protocol group (1 161 cases) and GnRH antagonist protocol group (806 cases); each group was divided into 4 subgroups according to age: ≤30 years, 31－35 years, 36－40 years and >40 years, the pregnancy outcomes in each age subgroup were analyzed under different controlled ovarian hyperstimulation protocols.Results:In early-follicular phase long-acting GnRH agonist long protocol group, the final live birth rates of each age subgroup were 39.4% (228/579), 36.1% (135/374), 16.6% (48/290) and 3.0% (4/132); in mid-luteal phase short-acting GnRH agonist long protocol group, live birth rates of each age subgroup were 32.1% (99/308), 20.8% (55/264), 13.0% (45/346) and 7.0% (17/243); in GnRH antagonist protocol group, live birth rates of each age subgroup were 22.8% (26/114), 16.3% (25/153), 11.2% (31/278), and 3.8% (10/261); the live birth rate of each group decreased significantly with the increase of age (all P<0.01). When the age≤35 years old, the fresh cycle live birth rate of the early-follicular phase long-acting GnRH agonist long protocol group was significantly better than those of the other two groups (all P<0.01). The multivariate logistic regression analysis of age and live birth rate of the three controlled ovarian hyperstimulation groups showed age was the independent influence factor ( OR=0.898, 95% CI: 0.873-0.916, P<0.01; OR=0.926, 95% CI: 0.890-0.996, P<0.01; OR=0.901, 95% CI: 0.863-0.960, P<0.01). Conclusions:Age is an independent influencing factor for the prediction of fresh cycle live birth rate in low ovarian response patients. No matter which controlled ovarian hyperstimulation protocol is adopted, the final live birth rate decreases significantly with the increase of women′s age. In addition, the early-follicular phase long-acting GnRH agonist long protocol has the highest fresh cycle live birth rate among all controlled ovarian hyperstimulation groups.
- [1]石礼红,纪亚忠,张迅轶,等.年龄对体外受精-胚胎移植妊娠结局的影响[J].2019,(1).
- [2]何钻玉,周冉,黄美凤,等.基础FSH与LH比值对年轻不孕患者控制性促排卵时卵巢反应性的影响[J].2011,(9).
- [3]万德花,程强军.不同年龄段PCOS患者血液AM H水平的临床研究[J].2018,(8).
- [4]陈子江,田秦杰,乔杰,等.早发性卵巢功能不全的临床诊疗中国专家共识[J].2017,(9).
- [5]代玮,胡琳莉.卵泡期长效长方案在低反应人群中的应用[J].2019,(10).
- [6]陈圆辉,王倩,张亚楠,等.抗苗勒管激素及年龄对体外受精-胚胎移植临床结局的预测价值[J].2019,(4).
- [7]Ferraretti AP,Nargund G,Tarlatzis B,etc.ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria.[J].2011,26(7).
- [8]Ensieh, Shahrokh Tehraninezhad,Fatemeh, Mehrabi,Raheleh, Taati,etc.Analysis of ovarian reserve markers (AMH, FSH, AFC) in different age strata in IVF/ICSI patients.[J].2016.
- [9]杨璞玉,马彩虹,陈立雪,等.减少胚胎移植数量对高龄妇女体外受精-胚胎移植临床结局的影响[J].2018,(10).
- [10]Juliano Brum, Scheffer,Bruno Brum, Scheffer,Rafaela Friche, de Carvalho,etc.Age as A Predictor of Embryo Quality Regardless of The Quantitative Ovarian Response.[J].1900,11.
- [11]Broekmans FJ,Dolleman M,Opmeer BC,etc.AMH and AFC as predictors of excessive response in controlled ovarian hyperstimulation: a meta-analysis.[J].2011,17(1).
- [12]Bar Hava, Itai,Blueshtein, Moran,Herman, Hadas Ganer,etc.Gonadotropin-releasing hormone analogue as sole luteal support in antagonist-based assisted reproductive technology cycles[J].2017,107(1).
- [13]M ?, Alebic,N, Stojanovic,D, Dewailly.Discordance between serum anti-Müllerian hormone concentrations and antral follicle counts: not only technical issues.[J].2018,33(6).
- [14]Casper, Robert F..Basic understanding of gonadotropin-releasing hormone-agonist triggering[J].2015,103(4).
- [15]齋藤敦.Society for Neuroscience meeting 2009に参加して[J].2010,49(1).
- [16]Sabatini L,Zosmer A,Hennessy EM,etc.Relevance of basal serum FSH to IVF outcome varies with patient age.[J].2008,17(1).
- [17]梁耀允,赵淑云,黄官友,等.卵泡期长方案中添加人绝经期促性腺激素对标准人群妊娠结局的影响[J].2021,(5).
- [18]Lambalk, C. B.,Banga, F. R.,Huirne, J. A.,etc.GnRH antagonist versus long agonist protocols in IVF: a systematic review and meta- analysis accounting for patient type[J].2017,23(5).
- [19]中国ART治疗低预后人群诊疗专家意见编写组.基于Delphi法的辅助生殖技术治疗低预后人群诊疗中国专家意见[J].2020,40(5).
- [20]Kingshuk Majumder,Tarek A. Gelbaya,Ian Laing,etc.The use of anti-Müllerian hormone and antral follicle count to predict the potential of oocytes and embryos[J].2010,150(2).
- [21]Michael,Grynberg,Julie,Labrosse.Understanding Follicular Output Rate (FORT) and its Implications for POSEIDON Criteria.[J].2019,10.
- [22]Lebovitz, Oshrit,Haas, Jigal,James, Kaitlyn E.,etc.The expected cumulative incidence of live birth for patients starting IVF treatment at age 41 years or older[J].2018,37(5).
- [23]Knee AB,Grow DR,Arny M,etc.Antral follicle count in clinical practice: analyzing clinical relevance.[J].2011,95(2).
- [24]Goldman, Randi H.,Farland, Leslie V.,Thomas, Ann Muir,etc.The combined impact of maternal age and body mass index on cumulative live birth following in vitro fertilization[J].2019,221(6).
- [25]De Geyter, Ch.,Calhaz-Jorge, C.,Kupka, M. S.,etc.ART in Europe, 2014: results generated from European registries by ESHRE[J].2018,33(9).