Effect of LH level on HCG trigger day on clinical outcomes in patients with diminished ovarian reserve undergoing GnRH-antagonist protocol.

IF 4.2 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Reproductive Biology and Endocrinology Pub Date : 2024-08-22 DOI:10.1186/s12958-024-01280-0

Qianjie Zhang, Kexin Zhang, Yu Gao, Shaojing He, Yicen Meng, Lei Ming, Tailang Yin, Jing Yang, Shuang Wu, Zhongming Zhou, Wei Li, Saijiao Li

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Abstract

Research question: Does luteinizing hormone (LH) levels on human chorionic gonadotropin (HCG) trigger day (LH_HCG) affect the clinical outcomes of patients with diminished ovarian reserve (DOR) undergoing gonadotropin-releasing hormone antagonist (GnRH-ant) protocol?

Methods: Retrospective analysis fresh embryo transfer cycles of DOR patients who underwent GnRH-ant protocol from August 2019 to June 2023. The participants were divided into different groups according to LH_HCG level and age. The clinical data and outcomes were compared between groups.

Results: In patients with DOR, the HCG positive rate (59.3% versus 39.8%, P = 0.005), embryo implantation rate (34.5% versus 19.7%, P = 0.002), clinical pregnancy rate (49.2% versus 28.4%, P = 0.003), live birth rate (41.5% versus 22.7%, P = 0.005) in LH_HCG < 2.58 IU/L group were significantly higher than LH_HCG ≥ 2.58 IU/L group. There was no significant correlation between LH_HCG level and clinical pregnancy in POSEIDON group 3. In POSEIDON group 4, the HCG positive rate (52.8% versus 27.0%, P = 0.015), embryo implantation rate (29.2% versus 13.3%, P = 0.023), clinical pregnancy rate (45.3% versus 18.9%, P = 0.010) in LH_HCG < 3.14 IU/L group were significantly higher than LH_HCG ≥ 3.14 IU/L group. Logistic regression analysis indicated that LH_HCG level was an independent influencing factor for clinical pregnancy in POSEIDON group 4 patients (OR = 3.831, 95% CI: 1.379-10.643, P < 0.05).

Conclusions: LH_HCG level is an independent factor affecting pregnancy outcome of fresh embryo transfer in DOR patients undergoing GnRH-ant protocol, especially for advanced-aged women. LH_HCG had a high predictive value for POSEIDON group 4 patients, and LH_HCG ≥ 3.14 IU/L predicts poor pregnancy outcomes.

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接受 GnRH-拮抗剂方案治疗的卵巢储备功能减退患者在 HCG 触发日的 LH 水平对临床结果的影响。

研究问题：人绒毛膜促性腺激素（HCG）触发日（LHHCG）的黄体生成素（LH）水平是否会影响接受促性腺激素释放激素拮抗剂（GnRH-ant）方案治疗的卵巢储备功能减退（DOR）患者的临床结果？回顾性分析2019年8月至2023年6月期间接受GnRH-ant方案的DOR患者的新鲜胚胎移植周期。根据 LHHCG 水平和年龄将参与者分为不同组别。比较了各组的临床数据和结果：在DOR患者中，LHHCG＜2.58 IU/L组的HCG阳性率（59.3%对39.8%，P=0.005）、胚胎植入率（34.5%对19.7%，P=0.002）、临床妊娠率（49.2%对28.4%，P=0.003）、活产率（41.5%对22.7%，P=0.005）均显著高于LHHCG≥2.58 IU/L组。在 POSEIDON 3 组中，LHHCG 水平与临床妊娠无明显相关性。在 POSEIDON 4 组中，LHHCG < 3.14 IU/L 组的 HCG 阳性率（52.8% 对 27.0%，P = 0.015）、胚胎着床率（29.2% 对 13.3%，P = 0.023）、临床妊娠率（45.3% 对 18.9%，P = 0.010）均明显高于 LHHCG ≥ 3.14 IU/L 组。逻辑回归分析表明，LHHCG 水平是 POSEIDON 第 4 组患者临床妊娠的独立影响因素（OR = 3.831，95% CI：1.379-10.643，P 结论：LHHCG 水平是 POSEIDON 第 4 组患者临床妊娠的独立影响因素：LHHCG水平是影响接受GnRH-ant方案的DOR患者鲜胚移植妊娠结局的一个独立因素，尤其是对高龄女性而言。LHHHCG对POSEIDON第4组患者有较高的预测价值，LHHHCG≥3.14 IU/L可预测不良妊娠结局。

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来源期刊

Reproductive Biology and Endocrinology 医学-内分泌学与代谢

CiteScore

7.90

自引率

2.30%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Reproductive Biology and Endocrinology publishes and disseminates high-quality results from excellent research in the reproductive sciences. The journal publishes on topics covering gametogenesis, fertilization, early embryonic development, embryo-uterus interaction, reproductive development, pregnancy, uterine biology, endocrinology of reproduction, control of reproduction, reproductive immunology, neuroendocrinology, and veterinary and human reproductive medicine, including all vertebrate species.