三种促排卵方案在高龄合并卵巢储备功能减退不孕症中 的应用比较.

Objective: To compare the application effects of three protocols of the controlled ovarian hyperstimulation in advanced-age patients with diminished ovarian reserve (DOR) when undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Methods：The data of 186 IVF/ICSIET cycles of advanced-age patients with DOR in the Department of Reproductive Medicine in Handan Central Hospital from June 2016 to January 2020 were retrospectively analyzed. According to the protocols of ovarian stimulation, the included subjects were divided into three groups: the progestin-primed ovarian stimulation (PPOS) group (n=61), the microstimulation group (n=65) and the GnRH antagonist (GnRHA) group (n=60). The differences in general conditions, treatment indicators and pregnancy outcomes were compared. Results：Compared with the microstimulation group, the PPOS group and GnRHA group had the prolonged duration of gonadotropin (Gn) and the increased total dosage of Gn, while both groups had the higher levels of serum E2 on hCG day (all P＜0.05). The numbers of oocytes retrieved were significantly increased, the numbers of available embryos and high-quality embryos increased, and the cycle cancellation rates were significantly decreased, the effective frozen -thawed embryo transfer (FET) cycle rate increased, in the PPOS group and GnRHA group when compared with the microstimulation group. Understandably, the cumulative pregnancy rates and the cumulative live birth rates in the PPOS group and GnRHA group were significantly higher than those in the microstimulation group (both P＜0.05). The serum level of LH on hCG day in the microstimulation group and PPOS group was higher than that in the GnRHA group (P＜0.05). The effective FET cycle rate in the PPOS group was significantly higher than that in the GnRHA group(P＜0.05). Conclusions：Those advanced-age patients with DOR can receive a good pregnancy outcome by using either PPOS protocol or GnRHA protocol during their IVF/ICSI-ET treatment cycles. Both of the two protocols are of feasible choice. [ABSTRACT FROM AUTHOR]