Gonadotropin Releasing Hormone-Antagonist Protocol (GnRH-ant) Combined Letrozole (LE) for Expected High Ovarian Responders (HOR): a Cohort Study.

IF 2.6 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Reproductive Sciences Pub Date : 2025-07-09 DOI:10.1007/s43032-025-01922-7

Wenxiao Feng, Min Zhou, Qiuying Li, Hui Chen, Jinyu Lu, Yang Sui

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引用次数: 0

Abstract

High ovarian responders are at high risk of developing ovarian hyperstimulation syndrome (OHSS) in in vitro fertilization (IVF). Letrozole administration during the gonadotropin period has the theoretical basis to avoid OHSS. But researches are just beginning. Our prospective cohort study was conducted to explore if the addition of LE are better or not. Totally 107 high responders who received IVF were included, 66 patients for GnRH-ant protocol and 41 patients for co-LE protocol with letrozole combination during gonadotropin period from day 1 to day 5. The IVF outcomes appeared: the clinical pregnancy rate, cumulative pregnancy rate, live birth and ongoing pregnancy rate were both comparable (p > 0.05). Patients in the co-LE group exhibited significantly less gonadotropin dose (1464.39 ± 550.84 vs. 1708.23 ± 455.75, p = 0.015), gonadotropin duration (9.63 ± 2.11 vs. 10.48 ± 1.83 days, p = 0.032) and oocytes number (13.29 ± 10.30 vs. 18.18 ± 9.36, p = 0.013). The incidence of early OHSS was significantly lower than that in the GnRH-ant group (0% & 13.6%, p = 0.025). According to our research, the combination of letrozole can improve controlled ovarian stimulation (COS) efficiency and reduce the risk of OHSS while bring effective IVF clinical outcomes equivalent to GnRH-ant regimen for ovarian hyperresponders.

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促性腺激素释放激素拮抗剂方案（GnRH-ant）联合来曲唑（LE）治疗预期的高卵巢反应（HOR）：一项队列研究。

高卵巢应答者在体外受精（IVF）中发生卵巢过度刺激综合征（OHSS）的风险很高。在促性腺激素期给予来曲唑有避免OHSS的理论依据。但研究才刚刚开始。我们进行了前瞻性队列研究，以探讨添加LE是否更好。在促性腺激素第1 ~第5天，接受IVF的高反应者107例，GnRH-ant方案66例，来曲唑联合le - le方案41例。结果显示：临床妊娠率、累计妊娠率、活产率和持续妊娠率均具有可比性（p < 0.05）。co-LE组促性腺激素剂量（1464.39±550.84∶1708.23±455.75,p = 0.015）、促性腺激素持续时间（9.63±2.11∶10.48±1.83天，p = 0.032）和卵母细胞数量（13.29±10.30∶18.18±9.36,p = 0.013）显著低于对照组。早期OHSS发生率显著低于GnRH-ant组（0% & 13.6%,p = 0.025）。根据我们的研究，来曲唑联合使用可以提高卵巢高反应者的控制性卵巢刺激（COS）效率，降低OHSS的风险，并带来与GnRH-ant方案相当的IVF临床结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive Sciences 医学-妇产科学

CiteScore

5.50

自引率

3.40%

发文量

322

审稿时长

4-8 weeks

期刊介绍： Reproductive Sciences (RS) is a peer-reviewed, monthly journal publishing original research and reviews in obstetrics and gynecology. RS is multi-disciplinary and includes research in basic reproductive biology and medicine, maternal-fetal medicine, obstetrics, gynecology, reproductive endocrinology, urogynecology, fertility/infertility, embryology, gynecologic/reproductive oncology, developmental biology, stem cell research, molecular/cellular biology and other related fields.