Trial of New Protocol (Modified Luteal Long; MLL) for Improvement of Outcomes in In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To evaluate the efficacy of new protocol (Modified luteal long; MLL protocol) to improve the clinical outcomes in IVF-ET. METHODS: New protocol was applied to repeated ART failure group for 7 months (GroupI, n=106) after informed consent. Outcomes of new protocol group were evaluated and compared to conventional long protocol group (Group II, n=315) prospectively and compared to same indication group with GroupI (Group III, n=144) historical prospectively. RESULTS: There were no differences in the clinical characteristics except patient's age between GroupI and II (35.16+/-4.35 vs. 33.22+/-4.14, p<0.05). Outcomes of IVF-ET, such as numbers of retrieved oocytes, numbers of transferred embryos, numbers of 2 PN, rates of ICSI, rates of blastocyst ET, rates of fertilization, ampules of gonadotropin between GroupI & II, and GroupI & III, respectively. But the embryo quality score of GroupII was significantly higher than GroupI. There was significant increase of implantation rate (25.2 vs. 17.1%, p=0.02) in GroupII compared to GroupI, especially in 31-35 years old group. Implantation rate of less than 35 years old group and clinical pregnancy rate of 31-35 years old group in GroupII tubal factor patients were significantly higher than GroupI tubal factor patients. Clinical pregnancy rate (47.2 vs. 12.8%, p=0.001) and implantation rate (15.2 vs. 5.5%, p=0.009) of GroupI was significantly higher than GroupIII, especially in 36-40 years old group. Implantation rates of ES factor patients (especially in 36-40 years old) and unknown factor patients (especially less than 35 years old), and clinical pregnancy rate of ES factor patients (especially in 36-40 years old) were significantly higher in GroupI than III. CONCLUSION: These results suggest that new protocol may play some role in the increase of endometrial receptivity. Further investigation, including molecular research work will be needed to clarify the factors concerned in the increase of implantation rate.