ABSTRACT
OBJECTIVE: To explore the effect of domestic recombinant follicle stimulating hormone(rFSH)in the course of controlled ovarian hyperstimulation using long protocol in patients with different ovarian reserve functions.METHODS: A retrospective cohort study was made on 1284 patients who were treated with in vitro fertilization/intracytoplasmic sperm injection-embryo transfer with standard long protocol for ovulation induction from January 2016 to January 2018 in Reproductive Medicine Center,Yuhuangding Hospital of Yantai. According to their AMH level,they were divided into normal ovarian reserve group(AMH:1.2-4.5μg/L,678 patients)and high response group(AMH>4.5μg/L,606 patients).Each group was divided into domestic rFSH subgroup(Jinsaiheng)(340 patients in normal ovarian reserve group,330 patients in high response group)and imported rFSH subgroup(338 patients in normal ovarian reserve group,276 patients in high response group)according to the different use of gonadotrophin on the start-up day.The clinical and laboratory indexes of the two subgroups were compared under different ovarian reserve functions.RESULTS: Regardless of normal or high ovarian reserve function,there was no significant difference in Gn dosage[(1983.15±510.00)U vs.(1913.32±422.12)U,P=0.053;(1816.86±506.37)U vs.(1786.63±453.90)U,P=0.44],days of Gn[(8.96±1.33)days vs.(8.87±1.24)days,P=0.36;(9.45±1.51)days vs.(9.44±1.47)days,P=0.91],dosage of Hermetic[(144.20±67.39)U vs.(143.42±56.73)U,P=0.86;(149.52±62.38)U vs.(160.21±84.87)U,P=0.09],number of eggs obtained(8.14±3.57 vs.8.44±3.37,P=0.25;11.47±4.74 vs.11.66±4.49,P=0.62),MⅡoocyte rate(82.08% vs. 82.01%,P=0.96;82.78% vs. 82.94%,P=0.90),fertilization rate(82.17% vs. 80.98%,P=0.30;80.75% vs. 82.16%,P=0.33),cleavage rate(94.55% vs. 93.91%,P=0.52;94.12% vs. 94.84%,P=0.49),blastocyst formation rate(58.43% vs. 59.55%,P=0.69;61.14% vs. 63.09%,P=0.46),clinical pregnancy rate(59.49% vs. 56.54%,P=0.54;62.84% vs.58.70%,P=0.57),early abortion rate(7.36% vs. 6.80%,P=0.42;11.30% vs. 11.11%,P=0.93)or the incidence of moderate to severe ovarian hyperstimulation syndrome(OHSS)(3.53% vs. 4.73%,P=0.71;7.58% vs. 9.06%,P=0.53)between the two subgroups.However,the daily LH level of HCG in domestic rFSH group was significantly higher than that in imported rFSH group[(2.83±1.31)U/L vs.(2.49±1.14)U/L,P=0.007;(2.35±1.10)U/L vs.(2.11±0.94)U/L,P=0.005].In the normal ovarian reserve group,the daily E2 concentration of HCG and the number of follicles above 1.6 cm in the domestic rFSH group were lower,but the rate of good quality embryos was significantly higher(67.23% vs. 62.51%,P=0.038),the difference being statistically significant(P=0.038).CONCLUSION: Domestic rFSH has the same clinical pregnancy outcome as imported rFSH after ovulation induction,but domestic rFSH has higher LH concentration on hCG day after ovulation induction,and patients with normal ovarian reserve have higher good quality embyro rate after using domestic rFSH.