Comparison between ultra-long-term down-regulation protocol and modified long-tem protocol in poor ovarian reserve patients / 中国综合临床

ABSTRACT

Objective To compare the outcomes in pregnancy between the patients with poor ovarian reservation receiving ultra-long-term down-regulation protocol and modified long-term protocol who were undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI),aiming at screening an optimal ovulation induction scheme.Methods Retrospectively analyzed the clinical data of 78 patients with poor ovarian reservation who underwent IVF or ICSI from October 2010 to July 2012.Forty-three patients received modified long-term protocol treatment (group A),with 0.375 mg long-acting triptorelin during the midluteal phase as well as superovulation start date plus alarelin (0.15 mg/d) to intramuscular injection of human chorionic gonadotropin (HCG) day.Thirty-five patients received ultra-long-term down-regulation protocol (group B).Triptorelin was injected intramuscularly in mid-luteal phase twice followed by triptorelin at a dose of 1.2-1.3 mg after 28 days of long-acting triptorehn treatment (1.5 mg).Gonadotropin was started 16 days after the second GnRHa injection.The dose of Gn,number of oocytes retrieved,number of embryos available,implantation rate,pregnancy rate,and miscarriage rate were recorded and compared between the two groups.Results There was no significant difference between the two groups in the mean age of participants,basal follicular number,FSH,the dose of Gn used,number of oocytes retrieved,number of embryos available,number of implanted embryos,Pregnancy rate(32.56％ vs.34.29％),implantation rate(18.75％ vs.20.97％) and miscarriage rate (0 vs.8.33％)(P ＞ 0.05).Conclusion No significant difference was found between the two groups in clinical pregnancy rate and abortion rate.But modified long-term protocol needs a shorter treatment period than the ultra-long-term protocol.Moreover,it reduces the risk of excessive suppression of pituitary function.Therefore,it takes advantages over the other in the clinical application.