Analysis of cumulative live birth rate outcomes of four ovarian stimulation protocols in Poseidon groups 3/4 patients with adenomyosis.

IF 2.7 3区医学 Q2 GENETICS & HEREDITY

Journal of Assisted Reproduction and Genetics Pub Date : 2025-06-01 Epub Date: 2025-05-09 DOI:10.1007/s10815-025-03488-4

Jiayi Guo, Jintao Peng, Yajie Chang, Yanfang Wang, Xiaoyan Liang, Rui Xiang

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引用次数: 0

Abstract

Purpose: To compare the effects of the gonadotrophin-releasing hormone (GnRH) agonist protocol, GnRH antagonist protocol, progestin-primed ovarian stimulation (PPOS) protocol, and mild stimulation/natural cycle protocol on the cumulative live birth rate (CLBR) in patients with adenomyosis and Poseidon group 3/4.

Methods: A total of 1090 patients diagnosed with adenomyosis and Poseidon groups 3/4 group who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) from January 2013 to December 2020 were included. Demographic characteristics, laboratory indicators, and clinical outcomes of the four ovarian stimulation protocols were compared. The primary outcome was the CLBR, with binary logistic regression analysis used to explore the factors influencing CLBR.

Results: Among the patients with adenomyosis and Poseidon groups 3/4, the CLBR in GnRH agonist protocol group was higher than that in PPOS protocol group (45.78% vs. 22.33%, P = 0.005). Binary logistic regression analysis revealed that GnRH agonist protocol had a higher CLBR compared to PPOS protocol (adjusted odds ratio (aOR) 3.26, 95% confidence interval (CI): 1.56-6.83, P = 0.002), while no significant differences were found when comparing PPOS protocol with GnRH antagonist protocol (P = 0.093) and mild stimulation/natural cycle protocol (P = 0.125). In the < 35 years subgroup, the CLBR of GnRH agonist protocol was significantly higher (55.26% vs. 33.82%; P = 0.032), which wasn't observed in elder subgroups (P > 0.05).

Conclusion: For patients with both adenomyosis and Poseidon groups 3/4, GnRH agonist protocol showed a higher CLBR, especially in patients < 35 years (Poseidon group 3).

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4种卵巢刺激方案对波塞冬组3/4例子宫腺肌症患者的累计活产率分析

目的：比较促性腺激素释放激素（GnRH）激动剂方案、GnRH拮抗剂方案、黄体酮刺激卵巢（PPOS）方案和轻度刺激/自然周期方案对子宫腺肌症和Poseidon组3/4患者累积活产率（CLBR）的影响。方法：选取2013年1月至2020年12月接受体外受精（IVF）或胞浆内单精子注射（ICSI）治疗的确诊为子宫腺肌症和Poseidon组3/4组患者1090例。比较四种卵巢刺激方案的人口学特征、实验室指标和临床结果。主要指标为CLBR，采用二元logistic回归分析探讨影响CLBR的因素。结果：子宫腺肌症组和Poseidon组3/4组患者中，GnRH激动剂方案组CLBR高于PPOS方案组（45.78%比22.33%,P = 0.005）。二元logistic回归分析显示，GnRH激动剂方案的CLBR高于PPOS方案（调整优势比（aOR） 3.26, 95%可信区间（CI）： 1.56 ~ 6.83, P = 0.002），而PPOS方案与GnRH拮抗剂方案（P = 0.093）和轻度刺激/自然循环方案（P = 0.125）比较无显著差异。0.05)。结论：对于子宫腺肌症组和Poseidon组3/4组患者，GnRH激动剂方案均显示更高的CLBR，特别是在患者中

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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.