Young obese patients may benefit from GnRH-a long protocol contributing to higher implantation rate and live birth rate of fresh IVF-ET cycles
Qi Wan,
Yue Qian,
Ming-Jing Xia,
Li Tan,
Xing-Yu Lv,
Xiang-Qian Meng,
Yu-Bin Ding,
Zhao-Hui Zhong,
Li-Hong Geng
Affiliations
Qi Wan
Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China; Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China
Yue Qian
Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
Ming-Jing Xia
Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China
Li Tan
The Department of Reproductive Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
Xing-Yu Lv
Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China
Xiang-Qian Meng
Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China
Yu-Bin Ding
Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China; Department of Pharmacology, Academician Workstation, Changsha Medical University, Changsha, 410219, China
Zhao-Hui Zhong
Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China; Corresponding author. Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
Li-Hong Geng
Chengdu Jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China; Corresponding author. Chengdu jinjiang Hospital for Women's and Children's Health, Chengdu, 610011, China.
Introduction: Obesity has detrimental influences on women reproductive health. There is little experience in optimizing controlled ovarian hyperstimulation (COH) protocols to treat Chinese obese patients who are undergoing in vitro fertilization and embryo transfer (IVF-ET) therapy. Methods: The clinical outcome differences were retrospectively analyzed among obese patients who received gonadotrophin-releasing hormone agonist (GnRH-a), GnRH antagonist (GnRH-ant), micro dose GnRH-a (mGnRH-a) and GnRH-a long protocol in IVF-ET cycle at Chengdu Jinjiang Hospital for Women's and Children's Health from January 2014 to December 2019. Results: The transplantation rate of the GnRH-a long protocol group (59.1%) was higher than that of the GnRH-ant (25.9%) and mGnRH-a (36.7%) groups. The total live birth rate of the GnRH-a long protocol group (46.2%) was higher than that of the GnRH-a group (25.9%) and GnRH-ant group (40.3%). The total number of frozen embryos in the GnRH-ant group was higher than in the other groups (P < 0.05). After adjusting for confounding factors, the logistic regression analysis showed that the GnRH-a long protocol group had higher probabilities of biochemical pregnancy, clinical pregnancy, and live birth than the GnRH-a protocol group. The Gn dose in the mGnRH-a group was higher than the other three groups. Whether single or twin, there were similar neonatal outcomes among the four groups including premature birth rate, Apgar score, newborn weight, and length. Conclusion: For young obese patients undergoing IVF-ET, the GnRH-a long protocol for COH gives better pregnancy outcomes.
