Effects of Different Ovulatory Drugs on Clinical Outcomes in the Long GnRH agonist Protocol with Suboptimal Ovarian Response / 中山大学学报(医学科学版)

ABSTRACT

@#【Objective】To investigate the effect of adding different preparations containing luteinizing hormone activity in patients with normal ovarian reserve but suboptimal response during GnRH agonist protocol when undergoing IVF/ICSI- ET.【Methods】872 infertile patients with normal ovarian reserve but suboptimal response to FSH during GnRH agonist protocol were enrolled. According to the supplementation of different preparations containing LH activity ，patients were divided into three groups，including low- dose hCG group（n=28），rLH group（n=319）and HMG group（n=525）. The clinical parameters and pregnancy outcomes were retrospectively compared among three groups.【Results】The proportion of ultra-long GnRH-a protocol in hCG group was higher than that in HMG group（14.3% vs. 1.1%，P＜0.001）. The total duration and dosage gonadotrophin in hCG group were more than that in HMG group ［15.0（13.0~16.8）vs. 13.0（12.0~15.0）days ，P = 0.027 ；2 925（2 531~3 900）vs. 2 550（2 100~3 225）U ，P = 0.046］. The total duration and dosage gonadotrophin in rLH group were less than that in HMG group［13.0（12.0~14.0）vs. 13.0（12.0~15.0）days，P = 0.009；2 400（1 950~3 075）vs. 2 550（2 100~3 225）U ，P = 0.009］. There were 53.6%（15/28）patients who still showed suboptimal response after the administration of HMG or rLH in hCG group. The clinical pregnancy rate（69.2%，58.6% vs.63.8%；P＞0.05）and live birth rate（65.4%，49.6% vs. 53.1%；P＞0.05）were similar among these groups.【Conclusions】 For patients with normal ovarian reserve but suboptimal response during GnRH agonist protocol ，the supplementation of different preparations containing LH activity showed comparable effect on pregnancy outcomes. The addition of low- dose hCG was effective even when patients still showed suboptimal response after the administration of HMG or rLH.