{"title":"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。","authors":"Qianjie Zhang, Kexin Zhang, Yu Gao, Shaojing He, Yicen Meng, Lei Ming, Tailang Yin, Jing Yang, Shuang Wu, Zhongming Zhou, Wei Li, Saijiao Li","doi":"10.1186/s12958-024-01280-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Research question: </strong>Does luteinizing hormone (LH) levels on human chorionic gonadotropin (HCG) trigger day (LH<sub>HCG</sub>) affect the clinical outcomes of patients with diminished ovarian reserve (DOR) undergoing gonadotropin-releasing hormone antagonist (GnRH-ant) protocol?</p><p><strong>Methods: </strong>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<sub>HCG</sub> level and age. The clinical data and outcomes were compared between groups.</p><p><strong>Results: </strong>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<sub>HCG</sub> < 2.58 IU/L group were significantly higher than LH<sub>HCG</sub> ≥ 2.58 IU/L group. There was no significant correlation between LH<sub>HCG</sub> 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<sub>HCG</sub> < 3.14 IU/L group were significantly higher than LH<sub>HCG</sub> ≥ 3.14 IU/L group. Logistic regression analysis indicated that LH<sub>HCG</sub> 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).</p><p><strong>Conclusions: </strong>LH<sub>HCG</sub> 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<sub>HCG</sub> had a high predictive value for POSEIDON group 4 patients, and LH<sub>HCG</sub> ≥ 3.14 IU/L predicts poor pregnancy outcomes.</p>","PeriodicalId":21011,"journal":{"name":"Reproductive Biology and Endocrinology","volume":null,"pages":null},"PeriodicalIF":4.2000,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340131/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of LH level on HCG trigger day on clinical outcomes in patients with diminished ovarian reserve undergoing GnRH-antagonist protocol.\",\"authors\":\"Qianjie Zhang, Kexin Zhang, Yu Gao, Shaojing He, Yicen Meng, Lei Ming, Tailang Yin, Jing Yang, Shuang Wu, Zhongming Zhou, Wei Li, Saijiao Li\",\"doi\":\"10.1186/s12958-024-01280-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Research question: </strong>Does luteinizing hormone (LH) levels on human chorionic gonadotropin (HCG) trigger day (LH<sub>HCG</sub>) affect the clinical outcomes of patients with diminished ovarian reserve (DOR) undergoing gonadotropin-releasing hormone antagonist (GnRH-ant) protocol?</p><p><strong>Methods: </strong>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<sub>HCG</sub> level and age. The clinical data and outcomes were compared between groups.</p><p><strong>Results: </strong>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<sub>HCG</sub> < 2.58 IU/L group were significantly higher than LH<sub>HCG</sub> ≥ 2.58 IU/L group. There was no significant correlation between LH<sub>HCG</sub> 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<sub>HCG</sub> < 3.14 IU/L group were significantly higher than LH<sub>HCG</sub> ≥ 3.14 IU/L group. Logistic regression analysis indicated that LH<sub>HCG</sub> 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).</p><p><strong>Conclusions: </strong>LH<sub>HCG</sub> 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<sub>HCG</sub> had a high predictive value for POSEIDON group 4 patients, and LH<sub>HCG</sub> ≥ 3.14 IU/L predicts poor pregnancy outcomes.</p>\",\"PeriodicalId\":21011,\"journal\":{\"name\":\"Reproductive Biology and Endocrinology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-08-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11340131/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reproductive Biology and Endocrinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12958-024-01280-0\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reproductive Biology and Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12958-024-01280-0","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Effect of LH level on HCG trigger day on clinical outcomes in patients with diminished ovarian reserve undergoing GnRH-antagonist protocol.
Research question: Does luteinizing hormone (LH) levels on human chorionic gonadotropin (HCG) trigger day (LHHCG) 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 LHHCG 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 LHHCG < 2.58 IU/L group were significantly higher than LHHCG ≥ 2.58 IU/L group. There was no significant correlation between LHHCG 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 LHHCG < 3.14 IU/L group were significantly higher than LHHCG ≥ 3.14 IU/L group. Logistic regression analysis indicated that LHHCG 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: LHHCG level is an independent factor affecting pregnancy outcome of fresh embryo transfer in DOR patients undergoing GnRH-ant protocol, especially for advanced-aged women. LHHCG had a high predictive value for POSEIDON group 4 patients, and LHHCG ≥ 3.14 IU/L predicts poor pregnancy outcomes.
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.
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