Smaller follicle diameter improves outcomes in natural LPOS: a retrospective cohort study.

IF 3.2 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-02-11 DOI:10.1007/s10815-025-03421-9

Jifan Tan, Sirui Liao, Dehai Gan, Guoqing Fan, Yanwen Xu, Jia Huang, Yuan Yuan

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引用次数: 0

Abstract

Background: This study aimed to investigate the optimal follicular diameter at the initiation of luteal-phase ovarian stimulation (LPOS) protocol after natural ovulation to achieve better laboratory outcomes.

Methods: This retrospective cohort study analyzed 286 in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles in patients who began the LPOS protocol after natural ovulation. Patients were categorized into three groups based on follicle diameter at initiation: small diameter follicles (SDF, < 5 mm, n = 74), medium diameter follicles (MDF, 5.0-7.9 mm, n = 140), and large diameter follicles (LDF, ≥ 8 mm, n = 72). Linear regression analysis was used to assess the relationship between initial follicle diameter and laboratory outcomes.

Result: Significant differences were noted in anti-Müllerian hormone (AMH), body mass index (BMI), and initial gonadotropin (Gn) dose among the groups. Primary outcomes included oocyte retrieval rate (SDF vs. MDF vs. LDF: 0.92 ± 0.88 vs. 0.68 ± 0.48 vs. 0.58 ± 0.54, p = 0.004), mature oocyte retrieval rate (0.78 ± 0.74 vs. 0.58 ± 0.43 vs. 0.51 ± 0.50, p = 0.01), and 2PN rate (0.58 ± 0.68 vs. 0.44 ± 0.40 vs. 0.36 ± 0.43, p = 0.03) in the SDF group were significantly higher than those in the MDF and LDF groups. Multivariate regression analysis, adjusting for potential confounders such as age, AMH levels, baseline follicle-stimulating hormone (FSH) levels, BMI, and initial Gn dosage, revealed negative correlations between the initial follicle diameter and oocyte retrieval rate (p = 0.02), mature oocyte retrieval rate (p = 0.02), and 2PN rate (p = 0.04).

Conclusions: Oocyte retrieval rate, mature oocyte retrieval rate, and 2PN rate decreased significantly with increasing follicle diameter at the initiation of LPOS. The optimal laboratory outcome was achieved with an initial follicle diameter of less than 5 mm.

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来源期刊

Journal of Assisted Reproduction and Genetics 医学-妇产科学

CiteScore

5.70

自引率

9.70%

发文量

286

审稿时长

1 months

期刊介绍： The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species. The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.