ABSTRACT
The clinical outcomes of five groups of infertility patients receiving frozenthawed,cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed.A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed,cleavage-stage embryo transfers from January 1,2012 to June 31,2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region.Based on the infertility etiologies of the patients,the 1003 cycles were divided into five groups:tubal infertility,polycystic ovary syndrome (PCOS),endometriosis,male infertility,and unexplained infertility.The main outcome was the live birth rate.Two groups were set up based on the intervention:group A was given a GnRH agonist with exogenous estrogen and progesterone,and group B (control group) was given exogenous estrogen and progesterone only.The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B.The live birth rates in groups A and B were 41.67％ and 29.29％,respectively (P＜0.05).The live birth rates in patients with PCOS in groups A and B were 56.25％ and 30.61％,respectively (P＜0.05).The clinical pregnancy,implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B.The ectopic pregnancy rate was significantly lower in group A than in group B.We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist cotreatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer.The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested,especially for women with PCOS.
ABSTRACT
The clinical outcomes of five groups of infertility patients receiving frozenthawed,cleavage-stage embryo transfers with exogenous hormone protocols with or without a depot gonadotropin-releasing hormone (GnRH) agonist were assessed.A retrospective cohort analysis was performed on 1003 cycles undergoing frozen-thawed,cleavage-stage embryo transfers from January 1,2012 to June 31,2015 in the Reproductive Medicine Center of Wuhan General Hospital of Guangzhou Military Region.Based on the infertility etiologies of the patients,the 1003 cycles were divided into five groups:tubal infertility,polycystic ovary syndrome (PCOS),endometriosis,male infertility,and unexplained infertility.The main outcome was the live birth rate.Two groups were set up based on the intervention:group A was given a GnRH agonist with exogenous estrogen and progesterone,and group B (control group) was given exogenous estrogen and progesterone only.The results showed that the baseline serum hormone levels and basic characteristics of the patients were not significantly different between groups A and B.The live birth rates in groups A and B were 41.67％ and 29.29％,respectively (P＜0.05).The live birth rates in patients with PCOS in groups A and B were 56.25％ and 30.61％,respectively (P＜0.05).The clinical pregnancy,implantation and on-going pregnancy rates showed the same trends as the live birth rates between groups A and B.The ectopic pregnancy rate was significantly lower in group A than in group B.We concluded that the live birth rate was higher and other clinical outcomes were more satisfactory with GnRH agonist cotreatment than without GnRH agonist co-treatment for frozen-thawed embryo transfer.The GnRH agonist combined with exogenous estrogen and progesterone worked for all types of infertility tested,especially for women with PCOS.
ABSTRACT
<p><b>OBJECTIVE</b>To assess the effect of repeated gonadotropic stimulations on the developmental potential and growth differentiation factor-9 (GDF-9) expression of mouse oocytes.</p><p><b>METHODS</b>Female Kunming mice were treated with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (HCG) for 3 times, and the control mice were treated with normal saline. The two groups of mice were both stimulated subsequently to obtain the mature oocytes. Immunocytochemical staining was employed to evaluate GDF-9 expression in the oocytes. The oocytes were then inseminated and cultured till the formation of blastocysts to compare the cleavage rate and blastocyst formation rate between the groups.</p><p><b>RESULTS</b>A total of 253 mature oocytes were obtained in the repeated stimulation group, with a mean of 11.5 oocytes from each mouse; 521 mature oocytes were obtained in the control group with a significantly greater mean number of 32.6 from each mouse (P<0.05). The average optical density and integrated optical density for GDF-9 expression were significantly lower in the oocytes in repeated stimulation group than in the control group (P<0.05 and 0.01, respectively). After insemination, the cleavage rate were comparable between repeated stimulation group and the control group (85.6% vs 88.8%), but the blastocyst formation rate was significantly lower in repeated stimulation group (20.8% vs 35.2%, P<0.01).</p><p><b>CONCLUSION</b>Repeated gonadal stimulation decreases the developmental potential of mouse oocytes possibly due to reduced GDF-9 expression.</p>